Barriers to implementing telerehabilitation in the Middle East and North Africa (MENA)

Naif Aljabri, Kim Bulkeley, Anne Cusick

Background: The need for rehabilitation services is unmet world-wide. However, in MENA Countries, rehabilitation is often unavailable or inadequate due to restricted access to limited services. Telerehabilitation has not emerged in MENA and has been shown to be an effective service delivery model in other regions.

Aims: To identify barriers to implementing telerehabilitation in MENA.

Methods: A comprehensive scoping review was conducted using the Arksey and O'Malley framework. In the initial search, 120 studies, were retrieved from 8 databases; 12 studies met the review inclusion criteria. The studies were collated, charted and summarised using thematic analysis.

Results: Recent studies that were included in the review came from 5 of the19 MENA countries: Iran, Israel, Jordan, Morocco and Saudi Arabia. The barriers to telerehabilitation are the most critical issue due to lack of information and communication technology (ICT) infrastructure/resources, privacy standardization, data protection regulation and agency collaborations. In relation to human capacity building, there are obstacles in using telerehabilitation as a result of patients and rehabilitation practitioners' awareness, attitudes, perspectives, limited technological knowledge, inadequate training and policymakers' attitudes. Despite this, there is a high acceptance among patients with diverse health conditions and rehabilitation practitioners in using telerehabilitation approach via different technologies.

Conclusions: Using telerehabilitation is highly accepted in MENA, however a number of implementation barriers exist. Telerehabilitation evolution and expansion is a feasible service alternative or addition to increase access to rehabilitation in MENA.