Facilitators and barriers to the development and implementation of national rehabilitation strategic plans: a qualitative descriptive study exploring the experiences across 19 Low- and Middle-income countries

Purpose: To identify facilitators and barriers to the development and implementation of national rehabilitation strategic plans across five World Health Organization (WHO) regions and 19 low- and middle-income countries. Materials and methods: A qualitative descriptive design was used. Ministry of Health personnel, WHO staff, international consultants, and development partners were purposively sampled. Data were analyzed using directed content analysis. Results: Five shared facilitators were identified: clarity of priorities, processes, impact, and contextual understanding; high-level political commitment, strong Ministry of Health leadership capacity and ownership; WHO’s sustained policy influence and diversified support; capacity, interest, and engagement of all relevant stakeholders; and enabling environments and institutional support mechanisms. Three shared barriers were identified: misconceptions and a narrow framing of rehabilitation; long-standing rehabilitation sector challenges; and gaps in rehabilitation data and information systems. Conclusions: Effective leadership, flexible processes, multisectoral collaboration, and prompt international assistance were key facilitators. However, persistent misconceptions about rehabilitation, insufficient data, fragmented governance, and frequent leadership changes were impeding progress and momentum. Aligning leadership, governance, and data systems is essential to move rehabilitation from policy intention to sustained, system-wide implementation.