Government to revamp rehab program following WHO evaluation that reveals shortcomings

The Federal Government and health stakeholders have initiated a comprehensive overhaul of Nigeria's rehabilitation system, prompted by a major national assessment that uncovered significant deficiencies in rehabilitation services nationwide.

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This development follows a National Stakeholders' Validation Meeting held in Abuja, which focused on implementing Rehabilitation 2030 through the World Health Organisation's Systematic Assessment of Rehabilitation Situation and Rehabilitation Maturity Model.

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The meeting brought together a diverse group of representatives from government ministries, agencies, academia, development partners, professional bodies, and rehabilitation service providers to assess the state of rehabilitation services in Nigeria and devise a plan for sectoral reforms.

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A communiqué issued on Wednesday by the Rehabilitation Technical Group underscored the critical importance of rehabilitation in strengthening health systems and achieving universal health coverage, describing it as "a critical component of health systems strengthening and an essential pathway towards achieving universal health coverage".

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The assessment, conducted in accordance with the WHO Rehabilitation 2030 Call for Action and the African Regional Rehabilitation Strategy (2025–2035), evaluated Nigeria's rehabilitation system across six key health system domains, revealing widespread systemic weaknesses and none of the 50 assessed components performing at an optimal level.

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Only two components demonstrated strong performance, while 16 were moderately developed and required strengthening, and 32 were operating at a "very low level", necessitating urgent establishment and broad system-wide intervention.

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Stakeholders identified several major problems affecting the sector, including weak governance structures, inadequate financing, poor data systems, workforce shortages, uneven infrastructure distribution, and limited accessibility of rehabilitation services.

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Additionally, they noted that rehabilitation was not explicitly captured in national health policies, and leadership and coordination mechanisms remained weak, with existing coordination efforts requiring reconsideration as part of wider sector reforms.

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Participants expressed concern over the absence of a dedicated rehabilitation budget, highlighting that limited insurance coverage had forced many Nigerians to rely on out-of-pocket payments for rehabilitation services.

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The meeting also revealed that rehabilitation data were not routinely integrated into the national health information system, limiting evidence-based planning and policy decisions, and stakeholders highlighted shortages of rehabilitation professionals, limited training institutions, and poor workforce distribution.

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Access to services remained a significant challenge, with rehabilitation care concentrated in a few tertiary health facilities, and community-based rehabilitation services largely absent within the public healthcare system.

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Low awareness and acceptability of rehabilitation services among healthcare workers and communities continued to affect referrals and service utilisation, despite areas of moderate progress, including patient-centred rehabilitation services and referral systems in some acute care settings.

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As part of the next steps, stakeholders resolved to produce a comprehensive report of the validation meeting within two weeks and finalise a clean draft of the STARS report, with a revised report incorporating stakeholder inputs to be submitted to the Federal Ministry of Health and Social Welfare and the MRTB by June 9.

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Consultations will continue through virtual and physical engagements to support refinement of the report and facilitate development of a National Rehabilitation Policy, with stakeholders emphasising the need for an implementation plan backed by a costed resource mobilisation framework and monitoring and evaluation systems.

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They also called for rehabilitation reforms to be adopted at the state level based on local needs and endorsed through the National Council on Health, amid growing concerns over Nigeria's increasing burden of disability, non-communicable diseases, stroke-related complications, injuries from road crashes, and age-related health conditions.

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Health experts have repeatedly warned that weak rehabilitation systems can worsen disability outcomes, reduce economic productivity, and place additional pressure on families and the healthcare system, underscoring the importance of the WHO's Rehabilitation 2030 initiative in strengthening rehabilitation services as part of universal health coverage and sustainable healthcare delivery.