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The first Global Symposium on Health Systems Research was held in 2010 under the leadership of the World Health Organization and the Alliance for Health Policy and Systems Research. Since [...]

Despite recognized need and reasonable demand, health systems and rehabilitation communities keep working in silos, independently with minimal recognition to the issues of those who require rehabilitation services. Consolidated effort by health systems and rehabilitation parties, recognizing the value, power and promise of each other, is a need of the hour to address this growing issue of public health importance. In this paper, the importance and the need for integration of rehabilitation into health system is emphasized. The efforts being made to integrate rehabilitation into health systems and the potential challenges in integration of these efforts were discussed. Finally, the strategies and benefits of integrating rehabilitation in health systems worldwide is proposed. Health policy and systems research (HPSR) brings a number of assets that may assist in addressing the obstacles discussed above to universal coverage of rehabilitation. It seeks to understand and improve how societies organize themselves to achieve collective health goals; considers links between health systems and social determinants of health; and how different actors interact in policy and implementation processes. This multidisciplinary lens is essential for evidence and learning that might overcome the obstacles to the provision of rehabilitation services, including integration into health systems. Health systems around the world can no longer afford to ignore rehabilitation needs of their populations and the World Health Assembly (WHA) resolution marked a global call to this effect. Therefore, national governments and global health community must invest in setting a priority research agenda and promote the integration of rehabilitation into health systems. The context-specific, need-based and policy-relevant knowledge about this must be made available globally, especially in low- and middle-income countries. This could help integrate and implement rehabilitation in health systems of countries worldwide and also help achieve the targets of Rehabilitation 2030, universal health coverage and Sustainable Development Goals. [ABSTRACT FROM AUTHOR]

Objectives: Trauma registries are essential tools for improving trauma care quality and efficiency, but many fail to capture long-term patient-reported outcome measures (PROMs). Focusing on these outcomes is crucial for understanding the extent of disability patients experience and identifying potential post-discharge interventions to optimize recovery. Studies reflecting the experience from low- and middle-income countries in this area are limited. Therefore, we aim to develop a digital trauma registry in Pakistan to prospectively capture patient-reported outcome measures at one, three, six, and twelve months post-injury. Methods: We will develop and implement a digital trauma registry at two tertiary care facilities in Karachi, Pakistan: Aga Khan University Hospital and Jinnah Postgraduate Medical Center. The registry will include all admitted adult trauma patients (≥ 18 years). Data collection will be conducted digitally using tablets, with mortality, level of disability, functional status, and quality of life as primary outcomes. Follow-up data will be collected through telephone interviews with patients and caregivers. We will employ descriptive statistics to summarize participant's socio-demographic and clinical characteristics. Additionally, we will perform survival analysis using Kaplan-Meier curves and Cox proportional hazard models and utilize mixed-effects linear regression to adjust for potential confounders for primary outcomes. Discussion: The trauma registry will fill the current gap in knowledge regarding long-term outcomes among trauma patients in low- and middle-income countries (LMICs). This study will delineate future direction for capturing post-discharge data, enhancing our understanding of recovery, and informing the design of interventions aimed at improving long-term outcomes. [ABSTRACT FROM AUTHOR]

The article offers information on the 2024 Global Symposium on Health Systems Research to be held in Nagasaki, Japan on November 18 to 22 which will focus on issues and developments in the science of health policy and systems.

Purpose: Road traffic injuries (RTIs) are a leading cause of disability in low- and middle-income countries. This study assesses the psychometric properties of 12-item World Health Organization Disability Assessment Schedule (WHODAS) 2.0 among patients with orthopedic injuries from road traffic crashes in Bangladesh across two timepoints after hospital discharge., Materials and Methods: Confirmatory factor analysis (CFA) assessed WHODAS 2.0 construct validity and investigated measurement invariance among a sample of RTI patients at an orthopedic hospital one month and three months post-discharge. Cronbach's alpha measured reliability., Results: A single-factor structure was identified in CFA for the one-month sample (χ2(53)=894.337, p  < 0.001; CFI = 0.989, TLI = 0.986; SRMR = 0.052, RMSEA = 0.151) and the three-month sample (χ2(53)=630.119, p  < 0.001; CFI = 1.000, TLI = 1.000; SRMR = 0.022, RMSEA = 0.130). Measurement invariance was supported, and internal consistency was excellent (α > 0.9) at each timepoint. Mean disability score decreased from 37.89 (out of 48, SD = 10.44) one-month post-discharge to 27.19 (SD = 18.10, p  < 0.001) three months post-discharge indicating improvement in functional status over time., Conclusions: WHODAS 2.0 is valid and reliable for measuring disability among patients with RTIs in Bangladesh and has validity for making meaningful comparisons in disability level over time. Future research should include samples with different types of RTIs to strengthen the evidence supporting the use of the instrument.