Empowering Primary Care with the World Health Organization’s Basic Package of Interventions for Rehabilitation: Developing a List of Interventions and a Clinical Resource

Background Primary health care (PHC) is crucial for achieving universal health coverage (UHC) and meeting health-related sustainable development goals, particularly in low resource settings. Rehabilitation, defined by the World Health Organization (WHO) as interventions designed to optimize functioning in individuals with health conditions in interaction with their environment, is a critical component of UHC that targets functioning needs. Despite its importance, access to rehabilitation services remains limited, particularly in primary care (PC) and low resource settings. To address this gap, the WHO developed the Basic Package of Interventions for Rehabilitation (Basic PIR), a toolkit designed to empower PC non-rehabilitation workers to deliver a prioritized set of easy, safe and effective interventions for rehabilitation through task-sharing. The objective of this article is to describe the participatory development process of the WHO’s Basic PIR, with a focus on the list of interventions and the clinical resource. Methods The development of the Basic PIR followed a three-phase methodology. Phase 1 identified the interventions for rehabilitation in PC settings. Phase 2 defined the core structure and content of the Basic PIR clinical resource. Phase 3 included preliminary field tests in selected countries, followed by reviews to evaluate and refine the prototype Basic PIR clinical resource. This participatory process, overseen by the WHO Rehabilitation Programme ensured the Basic PIR was tailored for use in PC and low-resource settings. Results In Phase 1, thirteen functioning domains related to health conditions were identified, leading to the preselection of 188 out of 297 interventions for rehabilitation from the WHO’s Package of Interventions for Rehabilitation (PIR), with 71 interventions ultimately included in the Basic PIR. Phase 2 involved creating the prototype, detailing the functioning domains with targets and corresponding interventions. In Phase 3, feedback from preliminary field tests in Ghana and Fiji, along with reviews, led to modifications, including revising rehabilitation steps and developing patient handouts. Conclusion By prioritizing patient-centered care and emphasizing functioning, the Basic PIR aims to improve access to rehabilitation services in PC and low resource settings, contributing to the achievement of UHC. Future pilot studies will evaluate its feasibility and acceptability, guiding its broader implementation.