02627nas a2200229   4500000000100000008004100001653006700042653001200109653003900121100001100160700001500171700001300186700001400199700001500213700001500228700001400243700001300257245014800270856009200418520187300510022001402383       2017                            d10aWorld Health Organization Global Disability Action Plan (GDAP)10aNigeria10aNeglected tropical diseases (NDTs)1 aKhan F1 aOwolabi MO1 aAmatya B1 aHamzat TK1 aOgunniyi A1 aOshinowo H1 aElmalik A1 aGalea MP00aChallenges and barriers for implementation of the World Health Organization Global Disability Action Plan in low- and middle- income countries.  uhttps://www.medicaljournals.se/jrm/content_files/download.php?doi=10.2340/16501977-22763 a<p><strong>OBJECTIVE: </strong>To identify potential barriers and facilitators for implementation of the World Health Organization Global Disability Action Plan (GDAP) in Nigeria and compare these with other low- and middle-income countries.</p>

<p><strong>METHODS: </strong>A rehabilitation team from the Royal Melbourne Hospital, Parkville, Australia, conducted intensive workshops at medical/academic institutions in Nigeria for healthcare professionals from various local Physical Medicine and Rehabilitation facilities. A modified Delphi method identified challenges for person with disability, using 3 GDAP objectives. Findings were compared with similar exercises in Madagascar, Pakistan and Mongolia.</p>

<p><strong>RESULTS: </strong>Despite differences in the healthcare system and practice, the challenges reported in Nigeria were similar to those in other 3 low- and middle-income countries, at both macro (governmental/policymakers) and micro levels (community/social/individual). Common challenges identified were: limited knowledge of disability services, limited Physical Medicine and Rehabilitation workforce, guidelines and accreditation standards; coordination amongst healthcare sectors; social issues; data and research; legislation and political commitment. Common potential facilitators included: need for strong leadership; advocacy of disability-inclusive development; investment in infrastructure/human resources; coordination/partnerships in healthcare sector; and research.</p>

<p><strong>CONCLUSION: </strong>Disability care is an emerging priority in low- and middle-income countries to address the needs of people with disability. The challenges identified in Nigeria are common to most low- and middle-income countries. The GDAP framework can facilitate access and strengthen Physical Medicine and Rehabilitation services.</p>
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