BackgroundHuman resources for rehabilitation are often a neglected component of health services strengthening and health workforce development. This may be partly related to weaknesses in the available research and evidence to inform advocacy and programmatic strategies. The objective of this study was to quantitatively describe the global situation in terms of supply of and need for human resources for health-related rehabilitation services, as a basis for strategy development of the workforce in physical and rehabilitation medicine.MethodsData for assessing supply of and need for rehabilitative personnel were extracted and analyzed from statistical databases maintained by the World Health Organization and other national and international health information sources. Standardized classifications were used to enhance cross-national comparability of findings.ResultsLarge differences were found across countries and regions between assessed need for services requiring health workers associated to physical and rehabilitation medicine against estimated supply of health personnel skilled in rehabilitation services. Despite greater need, low- and middle-income countries tended to report less availability of skilled health personnel, although the strength of the supply-need relationship varied across geographical and economic country groupings.ConclusionThe evidence base on human resources for health-related rehabilitation services remains fragmented, the result of limited availability and use of quality, comparable data and information within and across countries. This assessment offered the first global baseline, intended to catalyze further research that can be translated into evidence to support human resources for rehabilitation policy and practice.

This paper by Ximena Paz Aguilera and colleagues is a country case study for the Universal Health Coverage Collection, organized by WHO. It illustrates progress towards UHC and its monitoring and evaluation in Chile. Please see later in the article for the Editors' Summary

Since the detection of the first case of COVID-19 in Chile on March 3rd, 2020, a total of 513,188 cases, including ~14,302 deaths have been reported in Chile as of November 2nd, 2020. Here, we estimate the reproduction number throughout the epidemic in Chile and study the effectiveness of control interventions especially the effectiveness of lockdowns by conducting short-term forecasts based on the early transmission dynamics of COVID-19. Chile’s incidence curve displays early sub-exponential growth dynamics with the deceleration of growth parameter, p, estimated at 0.8 (95% CI: 0.7, 0.8) and the reproduction number, R, estimated at 1.8 (95% CI: 1.6, 1.9). Our findings indicate that the control measures at the start of the epidemic significantly slowed down the spread of the virus. However, the relaxation of restrictions and spread of the virus in low-income neighborhoods in May led to a new surge of infections, followed by the reimposition of lockdowns in Greater Santiago and other municipalities. These measures have decelerated the virus spread with R estimated at ~0.96 (95% CI: 0.95, 0.98) as of November 2nd, 2020. The early sub-exponential growth trend (p ~0.8) of the COVID-19 epidemic transformed into a linear growth trend (p ~0.5) as of July 7th, 2020, after the reimposition of lockdowns. While the broad scale social distancing interventions have slowed the virus spread, the number of new COVID-19 cases continue to accrue, underscoring the need for persistent social distancing and active case detection and isolation efforts to maintain the epidemic under control.

Background Ever since the implementation of the EU-Turkey deal, most refugees that enter Greece via sea are confined to the island on which they arrive until their asylum claims are adjudicated, where they generally reside in camps. Some of these camps have detention-like characteristics and dire living conditions, such as Moria camp on the island of Lesbos, Greece. Aid-organizations have stated that the situation in camp Moria deteriorates the mental health of its inhabitants and there is qualitative evidence to support this. This study explores the quantitative relationship between the incidence of acute mental health crises and the length of stay in the camp. Methods A cross-sectional study was conducted using routinely collected data on 856 consultations of 634 different patients during 90 nights at an emergency clinic in Moria camp. Logistic regression analysis was used to explore whether the length of stay in the camp was predictive of the occurrence of an acute mental health crisis. Results Of the 634 patients, the majority were men (59·3%), the average age was 23·2 years [0–71], and 24·3% was < 18 years. 25·5% (n = 218) of consultations were related to mental health problems; 17·0% (n = 37) of these met the study’s case definition of an acute mental health crisis. Such crises were positively associated with the length of stay in the camp (p = 0·011); the odds ratio of a mental health crisis increases with 1·03 for every 10% increase in days of residence in the camp. This is notable when considering the average length of stay in the camp is 71 days. Conclusion This study offers quantitative support for the notion that the adverse conditions in Moria camp deteriorate the mental health of its inhabitants as suggested in qualitative research. Although this study does not provide evidence of causality, it is likely that the poor and unsafe living conditions, challenging refugee determination procedures, and a lack of mental health services in the camp are significant contributing factors. We urgently call for Europe’s policymakers to honour the ‘51 Geneva refugee convention and terminate the neglectful situation on the Greek archipelago.