Mapping of mandated Rehabilitation services in India’s public health system: opportunities for mainstreaming rehabilitation

India has an estimated 440 million people requiring rehabilitation services, accounting for 70% of South-East Asia’s total rehabilitation need. Although rehabilitation is an essential strategy to achieve universal-health-coverage(UHC) and should be accessible to persons with rehabilitation needs, systematic information on services in public health-system are unavailable. Hence a mapping review was aimed at charting rehabilitation services across primary, secondary and tertiary-healthcare levels and identifying gaps relative to population needs. A mapping-review was conducted following the methodological framework for mapping-reviews and reported as per PRISMA-ScR 2020. Eligibility was structured using the Population–Concept–Context(PCC) framework. A three-step search strategy was applied. An initial search of PubMed and CINAHL to identify relevant text words and index terms; a comprehensive search of PubMed, CINAHL and Cochrane Library since inception to September 2025 limited to English language; and screening of reference lists supplemented by expert-consultation. Grey-literature was hand-searched across Indian Ministry, regulatory and international agency websites and the Shodhganga doctoral theses repository. Policy-documents, national-health-programmes and empirical-studies on rehabilitation service provision in India’s public-health-system at national and sub-national level were included; whereas private-sector services were excluded. Records were screened and data were charted and analysed against predefined themes based on the WHO Health-Systems Building-Blocks-framework. Of 820 records identified (549 from databases; 271 from grey-literature sources), 32 sources met the eligibility criteria and informed the synthesis: 4 scientific studies and 28 grey-literature documents covering disability and health programmes (16), insurance and financial-assistance schemes (9), and accessibility (3) mandates. Findings revealed that rehabilitation services were inadequate and fragmented across ministries and provisioned for disability. Services were disproportionate across healthcare levels; desirable at secondary healthcare levels and virtually absent at primary-healthcare, where they are most essential. Workforce estimates indicated severe shortage, particularly 0.58–0.88 rehabilitation-personnel per10,000 populations at community-health-centre and 0.20 per 10,000 at district-hospitals. The two most pronounced evidence gaps are health-workforce and health-information-systems. These findings are based on mapping of policy and grey literature rather than implementation data. Current gaps at national and sub-national levels warrant urgent action on mandating rehabilitation as essential rather than desirable at primary-care-level and shifting the focus from disability-centric to functioning-based services, aligned with WHO Rehabilitation-2030. Findings point to strengthening the evidence-base for developing India’s National Rehabilitation Strategic Framework in order to achieve the goal of rehabilitation for all.

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Journal
BMC Health Services Research
Published
2026-09-29
DOI
https://doi.org/10.1186/s12913-026-15659-9
Primary Topic
Cerebral Palsy and Movement Disorders
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article
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article

Mapping of mandated Rehabilitation services in India’s public health system: opportunities for mainstreaming rehabilitation

Ramandeep Kaur Saini, Prasad Waingankar, Tashi Tobgay, Harvinder Singh Chhabra et al.
BMC Health Services Research
Cerebral Palsy and Movement Disorders
article

Mapping of mandated Rehabilitation services in India’s public health system: opportunities for mainstreaming rehabilitation

Ramandeep Kaur Saini, Prasad Waingankar, Tashi Tobgay, Harvinder Singh Chhabra, Nitin N. Kadam, Bela M. Agarwal, Hanan Khalil, Rupali Roy, Alexandra Rauch, Swagatika Mishra, Chhaya Vijaykumar Verma, Raman Gangakhedkar, Prakash Prabhakarrao Doke, Chandana Bhagwat, Anjali Ravindra Bhise, Asha Chitnis, Anuradha A. Daptardar, Prakash Boominathan, Sanghamitra Pati, Gowri Nambiar Sengupta, Prashant M. Mullerpatan, Shreeja Nair, Yagna Shukla, Ashoo Grover, Shashank Dalvi, Nitesh Bansal, Abraham Samuel Babu, Priyanka Pareek, Sanjay Wadhwa, Rajani Mullerpatan, Shovan Saha, Savita Ravindra, John M. Solomon, Prasanna Lenka, Mariya Jiandani, Kuldip Salgotra, S. P. Goswami, Dipanwita Ghosh, Ravinder Singh, Charu Sharma, A. G. K. Sinha, Sudhirchandra Kadam, Sailakshmi Ganesan, Mohammed Asheel, Ketna L. Mehta, Uttara Deshmukh, M. C. Dash, Anita Gupta, Vaishali Sathe
article en

Abstract

India has an estimated 440 million people requiring rehabilitation services, accounting for 70% of South-East Asia’s total rehabilitation need. Although rehabilitation is an essential strategy to achieve universal-health-coverage(UHC) and should be accessible to persons with rehabilitation needs, systematic information on services in public health-system are unavailable. Hence a mapping review was aimed at charting rehabilitation services across primary, secondary and tertiary-healthcare levels and identifying gaps relative to population needs. A mapping-review was conducted following the methodological framework for mapping-reviews and reported as per PRISMA-ScR 2020. Eligibility was structured using the Population–Concept–Context(PCC) framework. A three-step search strategy was applied. An initial search of PubMed and CINAHL to identify relevant text words and index terms; a comprehensive search of PubMed, CINAHL and Cochrane Library since inception to September 2025 limited to English language; and screening of reference lists supplemented by expert-consultation. Grey-literature was hand-searched across Indian Ministry, regulatory and international agency websites and the Shodhganga doctoral theses repository. Policy-documents, national-health-programmes and empirical-studies on rehabilitation service provision in India’s public-health-system at national and sub-national level were included; whereas private-sector services were excluded. Records were screened and data were charted and analysed against predefined themes based on the WHO Health-Systems Building-Blocks-framework. Of 820 records identified (549 from databases; 271 from grey-literature sources), 32 sources met the eligibility criteria and informed the synthesis: 4 scientific studies and 28 grey-literature documents covering disability and health programmes (16), insurance and financial-assistance schemes (9), and accessibility (3) mandates. Findings revealed that rehabilitation services were inadequate and fragmented across ministries and provisioned for disability. Services were disproportionate across healthcare levels; desirable at secondary healthcare levels and virtually absent at primary-healthcare, where they are most essential. Workforce estimates indicated severe shortage, particularly 0.58–0.88 rehabilitation-personnel per10,000 populations at community-health-centre and 0.20 per 10,000 at district-hospitals. The two most pronounced evidence gaps are health-workforce and health-information-systems. These findings are based on mapping of policy and grey literature rather than implementation data. Current gaps at national and sub-national levels warrant urgent action on mandating rehabilitation as essential rather than desirable at primary-care-level and shifting the focus from disability-centric to functioning-based services, aligned with WHO Rehabilitation-2030. Findings point to strengthening the evidence-base for developing India’s National Rehabilitation Strategic Framework in order to achieve the goal of rehabilitation for all.

BMC Health Services Research
Tata Institute of Fundamental Research (IN), United Cerebral Palsy (US), Indian Academy of Pediatrics (IN), Manipal Academy of Higher Education (IN), King Edward Memorial Hospital and Seth G.S. Medical College (IN), La Trobe University (AU), Sri Ramachandra Institute of Higher Education and Research (IN), Symbiosis International University (IN), Lilavati Hospital & Research Centre (IN), Tata Memorial Hospital (IN), Indian Society of International Law (IN), Topiwala National Medical College & BYL Nair Charitable Hospital (IN), Indian Council of Medical Research (IN), Gujarat Cancer Society (IN), All India Institute of Physical Medicine and Rehabilitation (IN), World Health Organization (CH), Mahatma Gandhi Mission Institute of Health Sciences (IN), World Health Organization Regional Office for South-East Asia (IN), O. P. Jindal Global University (IN), Ministry of Health and Family Welfare (IN), Dr. S.R. Chandrasekhar Institute of Speech and Hearing (IN), S.L. Raheja Hospital (IN), UN Women’s Office for India, Bhutan, Maldives and Sri Lanka (IN), World Health Organization - India (IN), All India Institute of Medical Sciences (IN), Punjabi University (IN), Bharati Vidyapeeth (Deemed to be University) (IN), International Committee of the Red Cross (CH)
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Cerebral Palsy and Movement Disorders
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