Background 

The World Health Organization (WHO) defines rehabilitation as “a set of interventions designed to optimize functioning and reduce disability in individuals with health conditions in interaction with their environment.”1 It is a core component of Universal Health Coverage (UHC)2 that improves quality of life, reduces disability, and maximizes the effectiveness of health interventions. Despite being essential to ensuring continuity of care, rehabilitation is often under-prioritized in countries’ health systems and UHC strategies, and especially so in low- and middle-income countries (LMICs). The World Health Organization (WHO)’s Rehabilitation 2030 Call to Action (Rehab 2030) highlights this challenge and calls for a concerted effort by all stakeholders to strengthen rehabilitation in health systems.  

Through funding from the Leahy War Victims Fund (LWVF), the Health Systems Strengthening Accelerator (Accelerator)3 partnered with the Joint Learning Network for Universal Health Coverage (JLN)4 to facilitate cross-country dialogue on rehabilitation in health systems. As a first step, the Accelerator and the JLN co-hosted a public webinar on Rehabilitation and Universal Health Coverage in February 2022 that invited country policymakers and practitioners to learn about and discuss approaches to strengthening rehabilitation for UHC. Over 150 participants from 30 countries joined the webinar, demonstrating considerable demand for cross-country learning. In response, the Accelerator and the JLN hosted a Virtual Roundtable Series on Integrating Rehabilitation into Primary Health Care. From November 2022 to January 2023, 53 total participants from ministries of health, service delivery settings, non-governmental organizations, and universities in 18 countries came together to share their experiences advancing rehabilitation in health systems and primary health care (PHC). The roundtables surfaced clear country demand for guidance on how to improve awareness of what rehabilitation is, why it is important, and its benefits. 

Rationale: The need for effective strategic communication for rehabilitation 

As part of Rehab 2030, WHO recommends that country efforts to achieve UHC should include policies and actions to improve the accessibility, affordability, and quality of rehabilitation services.5 However, a lack of awareness and advocacy for rehabilitation translates to its exclusion from planning and health financing processes.6 Similarly, a lack of awareness of rehabilitation among health providers limits referrals for necessary rehabilitative care and patients also might not understand the benefits of rehabilitation that are available.7 Therefore, strategic communication on the importance of rehabilitation is needed across stakeholders – including government agencies, non-rehabilitation health workers, and communities. Effective strategic communication explores and addresses communication priorities for rehabilitation through deliberate, coordinated actions intended to inform, influence, or persuade key stakeholders.8 Given the range of rehabilitation stakeholders, it is necessary to tailor strategic communications to be accessible, actionable, credible, relevant, timely, and understandable to each stakeholders’ interests and capacities.9 

Activity Description 

The Accelerator will lead the ‘Strategic Communication for Rehabilitation in UHC’ activity to support rehabilitation stakeholders to engage in strategic communication and advocacy efforts to promote rehabilitation in UHC. The activity will apply the JLN Strategic Communication for UHC Practical Guide and accompanying Planning Tool alongside rehabilitation advocates and test different solutions to improve strategic advocacy efforts. These tools are intended to provide actionable guidance for communicating effectively to support UHC policy initiatives and will be adapted for rehabilitation. Participating countries will follow the first two phases of the guide – (1) identify communication priorities for rehabilitation and (2) develop an action plan. Where possible, the Accelerator may support rehabilitation stakeholders with the final phase (3) to implement and adapt the action plan through in-kind support for communication efforts (See Annex 1).     

Goal and objectives 

The main goal of this activity will be to empower rehabilitation stakeholders to explore and implement strategic communication and advocacy initiatives for rehabilitation in UHC in their respective countries. Specific objectives include: 

• • Equip rehabilitation advocates with tools and resources to effectively advocate for rehabilitation in UHC to other stakeholders (HSS, financing, UHC) where advocacy is needed 
  • Support cross-country experience-sharing and learning to identify common challenges and practical approaches to raising awareness of the importance of rehabilitation  

• • Promote global and country-level discourse on the role of rehabilitation in UHC 

After the activity, stakeholders will be able to: 

• • Identify the root cause(s) of low awareness and limited prioritization of rehabilitation 
  • Clearly articulate a ‘rehabilitation in UHC’ goal and identify policy stage  
  • Conduct governance and political economy analyses to identify barriers and drivers to rehabilitation in UHC 
  • Conduct a communication scan to identify potential internal and external barriers and opportunities that may affect communication efforts  
  • Prioritize a communication objective and identify a primary communicator 
  • Identify and analyze key stakeholders and prioritize audiences  
  • Develop key messages and choose tactics to deliver messages, including how to use data to promote advocacy for rehabilitation in UHC 
  • Develop a feasible plan of action plan with timelines, responsibilities, and required resources 
  • Develop a monitoring and evaluation plan to measure progress towards the communication objective 

Process 

To achieve the objectives of this activity, the technical facilitation team will support stakeholders to adapt and implement the Practical Guide and Planning Tool and to develop a case study documenting their experience. The team will also connect stakeholders to global evidence and a technical expert on strategic communication who will provide best practices and tailored guidance to stakeholders on awareness raising and advocacy for rehabilitation in UHC. 

Key approaches will include:  

• • Establishing working relationships and a common purpose for sharing learnings on countries’ rehabilitation efforts in health systems, root cause exercises, and initial objective setting 
  • Facilitating virtual sessions to share country experiences and support participants as they work through sections of the Practical Guide and Planning Tool with follow up on activities in-between sessions 
  • Using strong communication feedback loops to align country-level action with the learning exchanged in the virtual sessions 
  • Linking countries to global evidence through existing knowledge aggregators such as WHO guidance on rehabilitation and advocacy, including the World Rehabilitation Alliance, among others 
  • Capturing, documenting, and disseminating learning in short, practical case studies  

Expected Outcomes 

The intended outcomes of this exchange are the development of comprehensive strategic communication plans (including communication materials and resources) for rehabilitation and increased prioritization of rehabilitation within countries’ UHC agendas. Intended activities are: 

The technical facilitation team aims to be responsive to country participants regarding the modalities to be used and the outputs from this activity. The team may capture and synthesize additional key themes and practical lessons from countries’ implementation experience as a global public good for wider sharing and dissemination.  

Expected level of effort  

Participants will be expected to:  

• • Establish a multi-sectoral country team involved in the country’s rehabilitation, PHC, or UHC efforts 
  • Actively participate in virtual meetings   
  • Engage with, and be responsive to, the technical facilitator(s) via email, telephone, Zoom, including regular check-ins for feedback on country implementation progress and learnings 
  • Contribute to the development of case studies and other knowledge products, including providing inputs and feedback/suggestions via virtual meetings and emails 

Profile of participants 

Countries should form a team of 4-6 individuals to participate. It is important that the participants who are identified form a small, highly engaged team and can demonstrate the following success factors: 

• • Their commitment to action to raise awareness of rehabilitation in the country, such that their complementary strengths can be channeled towards collective action and improvement;  
  • Their understanding of the complexities involved in the prioritization of rehabilitation in the UHC agenda and current involvement in their country’s efforts, can provide valuable and practical insights on concrete challenges and solutions;  
  • Their time availability and ability to engage continuously with the activity. 

We expect country teams to include a diverse profile of participants, including participants drawn from a mixture of government and non-governmental organizations (national or sub-national). This may include participants from ministries of health and other relevant sectors, PHC and/or UHC agencies, policy units and/or service delivery professionals. The table below provides examples of the type of individual profiles you may select to form your team (all are not mandatory):  

 Maximum number of participants 

This activity will be limited to four countries with approximately 20-25 participants total. This EOI is open to responses from all countries. However, countries will be prioritized for selection based on relevance of country experience and being able to constitute a strong multi-sectoral team (see evaluation criteria below). 

Funding capacity 

This activity entails virtual engagement for a period of 8-10 months. No travel is anticipated at this time. 

Expression of interest process 

To launch this activity, the technical facilitation team welcomes all countries to submit an Expression of Interest (EOI) by May 26, 2023. Country participants are encouraged to work together to make a collaborative application. Countries should use this link to access a short EOI response form where your country team will provide the following information:  

• • The relevance to the country on the need to elevate advocacy for rehabilitation in UHC; 
  • Any planned or ongoing communication/advocacy activities related to rehabilitation in the country;  
  • How the activity will support the objectives and activities of your institutions/organizations;  

• • How knowledge and tools from this activity will be used to promote rehabilitation in UHC in the country 
  • Proposed country participants’ name, email address, title/position, institution/organization, professional background, and relevance of this activity to their daily work;   

All applications will be reviewed, and decisions communicated by June 9, 2023. If you are not able to access the EOI response form, are interested in participating but may not have all the above information available by the EOI deadline, or have any questions related to the application, please contact Reva Alperson at ralperson@r4d.org. 

Deadline and instructions for submission  

Please submit your EOI via this link by May 26, 2023. All applications will be reviewed, and decisions communicated by June 9, 2023. 

Evaluation criteria 

Prospective countries should meet the following criteria:  

• • Must demonstrate an existing, planned or in-process policy or guideline that includes strengthening or integrating rehabilitation in health systems and/or how this links to the broader goal of improving UHC;  
  • Must demonstrate a clear plan on how support from this implementation activity will be rapidly translated to country action;  
  • Must propose a strong, multi-sectoral team representing institutions/organizations as suggested in the participant profiles.