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Table 2 Priority set of 59 indicators rated above average for relative importance, arranged by cluster in descending order of importance

From: Using concept mapping to develop a human rights based indicator framework to assess country efforts to strengthen rehabilitation provision and policy: the Rehabilitation System Diagnosis and Dialogue framework (RESYST)

Noa Indicators per cluster Importance
  Mean SSD
  Legal Commitments and Strategic Priorities 3.15 b −0.87
63 c  The State has a law to ensure universal access to comprehensive rehabilitative care and assistive products for all (yes/no). 3.43 −0.77
79  State law explicitly prohibits discrimination in health insurance on the ground of disability or other pre-existing condition (yes/no). 3.42 −0.77
17  National health or disability strategy addresses priority health related rehabilitation issues (yes/no). Describe and specify. Timeframe and coverage. 3.41 −0.76
50  Evidence documenting (a) establishment of an operational, budgeted, multi sectoral national rehabilitation action plan aligned with WHO international and or regional action plans, (b) target setting process, (c) implementation activities, (d) monitoring and evaluation plan. 3.41 −0.72
20  Constitutional guarantees to disability equality - The State takes at least one approach to disability equality and non-discrimination (yes/no). 3.35 −0.92
15  The concept of disability used in health laws, policies, programmes and regulations and in the collection of relevant statistical data is in line with the human rights approach to disability and the protection of the rights of all persons with disabilities regardless of impairment (yes/no) 3.28 −0.88
66  National disaster preparedness and relief plans are inclusive of health related rehabilitation (yes/no). 3.27 −0.8
81  Legally binding national accessibility standards/guidelines established and documented (yes/no). Year of adoption. 3.22 −0.93
97  Existence of an Operational Unit, Branch or Dept. in the Ministry of Health (or other Ministry) with responsibility for rehabilitation services/ assistive technologies policy development, implementation, monitoring and evaluation (yes/no). Jurisdiction and scope. 3.22 −0.79
35  Status of ratification of international human rights treaties recognizing the right to health and their optional protocols. 3.19 −0.88
14  Date of entry into force and coverage of domestic legislation for the implementation of the right to health of persons with disability, including legislation on rehabilitation care. 3.14 −0.79
88  Existence of government approved evidence based guidelines for the rehabilitation of a wide range of disabling conditions through a multidisciplinary team approach (yes/no). 3.03 −0.83
103  Legislative provision prohibiting compulsory medical treatment and experimentation (yes/no). 2.97 −1.07
28  State regulations require healthcare providers to implement policies, procedures and/or protocols for partnering with patients, carers and consumers in: (i) Strategic and operational/services planning (yes/no) (ii) Decision-making about safety and quality initiatives (yes/no) (iii) Quality improvement activities (yes/no). 2.95 −0.78
83  Date of entry into force and coverage of the right to health of persons with disability in the constitution or other form of superior law. 2.89 −0.99
  Monitoring and Accountability 3.03 −0.83
58  Existence of a national set of relevant indicators with targets and annual reporting to inform annual rehabilitation sector reviews and other planning cycles (yes/no). 3.24 −0.89
48  The State has conducted an overall assessment of the performance of the rehabilitation care system in the last 5 years (yes/no). 3.24 −0.8
37  Availability of an integrated information system on the health-related rehabilitation workforce, providing periodically updated data on the size, type, geographical distribution, competencies and skill mix of the national stock of workers. 3.19 −0.78
18  Rehabilitation service delivery regulations, quality specifications and professional standards are established and documented (yes/no).Year of last update. 3.14 −0.75
52  Existence of a unified accounting system to track allocation of funds to health related rehabilitation services integrated within the overall health expenditure tracking system (yes/no). 2.95 −0.88
  Evidence Informed and Rights Based Programming 2.96 −0.86
67  Evidence on the existence of formal collaboration between (a) the department/agency responsible for rehabilitation and (b) the department/agency responsible for: (i) employment, (ii) education, (iii) welfare (iii) CRPD implementation. 3.35 −0.63
57  State has established inclusive procedures or mechanisms for consultation with disabled people’s organizations at national, sub-national and local levels (yes/no). 3.35 −0.72
40  Existence of national multi-sectoral commission, agency or mechanism for the coordination of disability policy and the implementation of the CRPD (yes/no). Scope & functions. 3.33 −0.83
24  Charter of patient rights published and available in accessible formats (yes/no). 3.08 −0.89
70  The State has a systematic plan and coordinating unit for acquiring and using rehabilitation research information and for sharing and transferring knowledge (yes/no). 3 −0.78
75  Existence of a participatory forum and disability inclusive process to coordinate the setting of national rehabilitation research priorities (yes/no). 2.95 −0.94
71  The State has a budgeted plan to raise awareness about disability issues among health professionals which involves persons with disabilities and their representative organizations (yes/no). Timeframe and coverage. 2.92 −0.8
100  Existence of accessible pre-judicial mechanisms to lodge complaints alleging breach of obligations connected to the right to health. Jurisdiction and scope. 2.92 −0.83
44  Existence of a government website which meets the ISO/IEC 40500:2012 standards of accessibility for web content with latest report and data about rehabilitation services available to the general public (yes/no). 2.89 −0.97
  Workforce Development 2.91 −0.87
19  Existence of disability human rights education as an element of the accreditation standards used at the national level in the field of rehabilitation. 3.03 −0.76
51  Availability of ethical standards of care for rehabilitation physicians and allied health professionals (yes/no). 3 −0.78
69  Existence of human resources for health unit that is responsible for developing and monitoring policies and plans on rehabilitation workforce and negotiating intersectoral relationships with other line ministries and stakeholders (yes/no). 2.89 −0.94
  Access Barriers 2.89 −0.86
46  Barriers in access to medical rehabilitation (%) - Reported number of persons with disabilities not having access to medical rehabilitation services due to transportation barriers, physical/geographical access barriers, waiting time, lack of information; lack of time; inadequate skills of service provider; cost or other. 3.64 −0.59
92  Percentage (%) of health facilities providing medical rehabilitation services. 3.08 −0.76
107  Needs for assistive products met - Reported number of persons with disability using an assistive product that fits their functional needs. 3.06 −0.75
26  Inequality in access to rehabilitation - Absolute difference in unmet needs for rehabilitation between people with and without clinical impairments/disabilities (trends). 3 −0.94
55  Timely access to rehabilitation 2 - Time (median waiting time in days) between: (i) acute hospital admission until referral for rehabilitation, (ii) referral until assessment, (iii) acceptance by post-acute rehabilitation care and ready for transfer until admission. 2.97 −0.93
78  Proportion of the population living within four hours travel to a rehabilitation/assistive technology service (Allows for visiting a service within a day.) 2.92 −0.98
82  Assistive technology affordability - Percentage (%) of the per capita GDP or income required to purchase a wheelchair (average price). 2.92 −0.87
  Service Coverage, Utilization and Outcomes 2.87 −0.85
65  Unmet needs for medical rehabilitation - Reported number of persons with disability that needed medical rehabilitation services or assistive devices in the last 12 months and did not get the services they need, stratified by age, income, geographic region and educational level 3.46 −0.77
7  Number of Community Based Rehabilitation providers/population ratio (per 100,000) 3.27 −0.69
31  Financial barriers in access to assistive technology - Reported number of persons with disability who didn’t get their prescribed assistive devices because of their cost 3.22 −0.8
96  Financial barriers in access to rehabilitation - Reported number of persons with disability that have forgone prescribed rehabilitation treatment due to financial reasons in the last 12 months, disaggregated by income level, sex and age 3.19 −0.84
10  Number of multidisciplinary rehabilitation programmes per 1,000,000 - (e.g., cardiac, cancer, stroke, spinal cord injury, paediatric rehabilitation programmes). 3.16 −0.76
61  Patient status at discharge - National average percentage (%) of rehabilitation inpatients with improved function scores at discharge (compared with scores measured at admission). 2.92 −0.97
29  Proportion of persons with disability living in complex emergency environments that can access comprehensive rehabilitation services 2.92 −0.89
  Service Financing and Quality Control 2.82 −0.85
33  A comprehensive array of medical rehabilitation services is enlisted in the State’s essential health benefits package including for the purpose of maintaining current levels of functioning (yes/no). Describe and specify. 3.33 −0.83
11  Percentage (%) of WHO recommended priority assistive products included in the national assistive products list for procurement and reimbursement. 3.3 −0.78
73  Expenditure trends on (i) rehabilitation care (inpatient, outpatient and community based) as % of government health expenditure (ii) assistive products as % of government health expenditure. 3 −0.82
9  Percentage (%) of health facilities/units offering medical rehabilitation with established quality improvement teams, by facility type. 2.97 −0.9
21  Evidence (including of qualitative nature) of gender sensitiveness of rehabilitation services. 2.95 −0.85
36  The State subsidizes disabled people’s travel costs to access rehabilitation services that are not available near their place of residence. 2.95 −0.85
  Higher Education 2.82 −0.85
25  Training in physical medicine and rehabilitation available for doctors. This refers to a residency programme in Physical Medicine and Rehabilitation (PMR) or specialist certification in PRM which is recognized by the medical council or the equivalent licensing body of the country (yes/no). 3.03 −0.83
  Workforce Planning and Performance 2.76 −0.85
13  Self-perceived community integration – Percentage (%) of survey respondents with disability who would rate their level of community integration as “7”out of “10” or higher. 3.03 −0.96
4  Percentage (%) of persons with disability reporting having personally felt discriminated against or harassed during rehabilitation within the last 12 months on the basis of a ground of discrimination prohibited under international human rights law (compared to people without disability). 3.03 −0.8
64  Percentage (%) of persons with disability that feel they have received sufficient information and been sufficiently involved in making decisions about their rehabilitation treatment compared to people without disability 2.95 −0.91
86  Rehabilitation workforce density by occupation/specialization and activity level. 2.89 −0.84
91  Percentage (%) of rehabilitation service users who said they have been sufficiently involved in decisions about their care as much as they wanted to be. 2.89 −0.82
  Disability Statistics 2.74 −1.06
5  Return to work rates - Average national percentage (%) of vocational rehabilitation clients of working age who are engaged in sustainable employment 3–6 months after closure and were employed before entering vocational rehabilitation. 3.11 −1.02
  1. aNumber corresponds to the number that was randomly assigned to the indicator after the brainstorming phase
  2. bCluster rating scores are based on the mean rating for all indicators within the cluster
  3. cBolded numbers indicate inclusion of the indicator in the implementation priority set (Tier 1)