Rehabilitation Governance: The Evidence Gap Nobody Talks About

At ISPRM25 in Marrakesh, Carlotte Kiekens presented key findings from the work of Cochrane Rehabilitation and the ISPRM–WHO Liaison Committee, focusing on a newly completed Cochrane Overview on governance arrangements for rehabilitation services.

Kiekens explained that she took part in two sessions during the Congress: one organized by the Cochrane Thematic Group on Cochrane Rehabilitation, and another by the ISPRM–WHO Liaison Committee. In both contexts, she stressed the same message: «with Cochrane Rehab, we are performing Cochrane overviews of systematic reviews on health systems and policy research» .

This effort responds directly to the World Health Assembly resolution “Strengthening Rehabilitation in Health Systems,” which calls for Health Policy and Systems Research in rehabilitation. Improving access and upgrading services worldwide require evidence on health policy and health systems, not only clinical interventions.

Kiekens described how the project was structured. Last year, Cochrane Rehabilitation began working on four overviews based on the EPOC taxonomy, which covers service delivery, financing, governance and implementation strategies. These overviews analyse quantitative studies, including randomized and non-randomized research, to understand what evidence exists in the field of rehabilitation-related HPSR.

She announced that the first completed overview — on governance — has just been published. The results, however, reveal an absence of solid evidence. As she stated, «it is an empty review. We only find some studies of bad quality. So we can’t make any conclusions unless that there is a gap» . Upcoming overviews on financing, implementation strategies and service delivery are expected to contain more information.

Kiekens encouraged colleagues to stay updated on this work, noting: «We will spread these overviews» .