Abstract

Objectives: Despite policy commitments to disability inclusion, access to rehabilitation in Bangladesh remains limited, particularly among rural and low-income populations. Rising non-communicable diseases, population ageing, and refugee-related service pressures intensify demand for long-term accessible rehabilitation services. Community-based rehabilitation (CBR) offers a system-level strategy to improve equitable access; however, implementation remains fragmented and insufficiently integrated into national health planning. In this review, we discuss the current status of CBR in Bangladesh, identifies system gaps, and outlines policy priorities for scale-up.

Materials and methods: A descriptive mixed-methods design combined a narrative review of national policies, World Health Organization (WHO) position papers, and reports from government, non-governmental organizations (NGO), with semi-structured key informant interviews involving policymakers, rehabilitation professionals, NGO representatives, and community service providers. Data were mapped to the WHO’s six health-system building blocks and analyzed thematically to assess healthcare infrastructure, workforce, financing, service delivery, governance, and assistive technology.

Results: Rehabilitation resources in Bangladesh remained centralized and underfunded with less than 1% of the health budget allocated to rehabilitation and critical shortages of trained personnel concentrated in urban centers. Existing CBR programs were predominantly NGO-driven with heterogeneous models, limited geographic coverage, and weak linkage to primary healthcare. Governance fragmentation, absence of a national CBR policy, inadequate disability data systems, and limited assistive technology provision further constrained implementation. However, opportunities existed to leverage 13,000 community clinics, task-sharing approaches by partner organizations, and tele-rehabilitation to expand services.

Conclusion: Community-based rehabilitation in Bangladesh is implementable, despite being constrained by weak policy integration, limited human resource capacity, and fragmented governance. A national CBR policy aligned with universal health coverage is needed to embed rehabilitation within primary healthcare, develop a regulated workforce with task-sharing models, strengthen assistive technology systems, and establish sustainable financing mechanisms. Coordinated multi-sectoral governance and public-private partnerships are essential to scale equitable, community-level rehabilitation and support long-term health system resilience.

Citation: Uddin T, Akhtaruzzaman M, Newaz F, Rahman A, Azad AK. Community based rehabilitation in a developing country: A descriptive analysis of gaps, challenges and opportunities for implementation. Arch ISPRM 2026;1(2):128-137. https://doi. org/10.5606/archisprm.2026.30.

T.U., F.N.: Concept; T.U., F.N., A.R.: Design; T.U., M.A., A.K.A.: Supervision; M.A., A.R., F.N.: Data collection and processing; T.U., A.R., F.N.: Analysis and interpretation; T.U., F.N., A.K.A.: Literature review; T.U., M.A., F.N.: Writing the article; T.U., M.A., A.K.A., F.N.: Critical review; F.N., A.R.: References and fundings; A.R., A.K.A.: Materials.

The authors declare that there are no conflicts of interest with respect to the research, authorship, and/or publication of this article.

Data Availability
The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.

This research received no specific grant from any funding agency in the public, commercial, or not‑for‑profit sectors.

AI Disclosure
The authors declare that artificial intelligence (AI) tools were not used, or were used solely for language editing, and had no role in data analysis, interpretation, or the formulation of conclusions. All scientific content, data interpretation, and conclusions are the sole responsibility of the authors. The authors further confirm that AI tools were not used to generate, fabricate, or ‘hallucinate’ references, and that all references have been carefully verified for accuracy.