Medical rehabilitation in low and middle income countries for adult acquired disability: challenges posed by rapidity of health system change and position on the individualistic/collectivist axis.

  • Karl Sandin University of Chicago
Keywords: medical rehabilitation, low and middle income countries, health systems, disability, theology, interdependence, individual-collectivist axis


Chronic illness prevalence has rapidly increased in low or middle income countries (LMIC) and with it, the need for medical rehabilitation for adults with acquired conditions that stem from aging and long-term conditions.  While Western medical rehabilitation programs have had at least two generations to develop, in LMIC, post-acute health care delivery change has been much more rapid.  As a result, there has been little opportunity for models of medical rehabilitation to deliberately emerge in LMIC that reflect societal values.  While adaptation of an independence-foremost model of medical rehabilitation may succeed in non-Western societies, there is a risk that adaptation of such a model will be ineffective where many value collectivism more than individualism.  The rapid change in medical rehabilitation service delivery in LMIC gives Christian providers and organizations an opportunity to pause and reflect whether the dominant Western medical rehabilitation paradigm serves LMIC cultures and reflects Biblical principles.

Author Biography

Karl Sandin, University of Chicago
Karl Sandin MD MPH is clinical associate at the University of Chicago Pritzker School of Medicine,President and Medical Director of Schwab Rehabilitation Hospital and Chair of physical medicine and rehabilitation Sinai Health System


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