Title : Neurorehabilitation services in a South Indian Rehabilitation Institute (SIRI) – Issues and challenges
Abstract:
India faces a growing burden of neurological conditions such as stroke, traumatic brain injury, and neurodegenerative disorders. However, the availability and accessibility of neurorehabilitation services remain limited and uneven. This problem is expected to worsen due to the rising trend of non-communicable diseases and demographic shifts associated with increased life expectancy. In India, a majority of individuals with disabilities reside in rural areas, where accessibility, availability, cost-effectiveness, and utilization of rehabilitation services are significant concerns.
The high burden of neurological disorders, combined with a shortage of neurorehabilitation services, presents a significant barrier to effective neurorehabilitation. Furthermore, there is a notable lack of government-led neurorehabilitation services in India, creating critical gaps in care. In this context, our rehabilitation institute has taken on a pivotal role in partially addressing this need by providing accessible services to communities in our region. Rehabilitation services are often concentrated in urban centers, making access difficult for the large rural population in need. Not all rehabilitation services are covered by insurance, making it even more challenging for individuals to afford necessary care.
This presentation explores the practical challenges and systemic barriers encountered in delivering neurorehabilitation services at a leading rehabilitation institute in South India. Despite increasing demand from patients with stroke, spinal cord injury, traumatic brain injury, and other neurological conditions, the institute operates under constraints typical of low-resource settings. Key challenges include limited access to multidisciplinary teams and a shortage of trained professionals—particularly Physical Medicine and Rehabilitation (PMR) physicians, occupational therapists, and speech therapists with expertise in neurorehabilitation. Additional barriers include inadequate funding and poor integration of rehabilitation with primary and community health systems.
Our experience highlights marked urban-rural disparities in service access, inconsistent referral pathways, and limited public awareness regarding the benefits of early and sustained rehabilitation. Financial constraints, particularly for long-term therapy, remain a major deterrent for many patients. Nevertheless, the institute is working to overcome some of these barriers through low-cost rehabilitation models.These innovations demonstrate the potential for scalable solutions, though sustained support through policy reforms, workforce development, and infrastructure investment is essential.This case study provides valuable insights into the broader challenges of delivering effective neurorehabilitation in resource-limited environments and proposes context-specific strategies that could be adapted globally.
Keywords: Neurorehabilitation, South India, resource-limited settings, workforce, access to care
Audience Take Away Notes:
•An overview of a cost-effective rehabilitation model in resource-limited environments.
•Provide an in-depth understanding of the issues and challenges in delivering neurorehabilitation services through a low-cost rehabilitation model.
•Provide newer insights into the broader challenges of delivering effective neurorehabilitation.
