Rehabilitation in primary health care: workforce and pathways toward 2030.

INTRODUCTION

The World Health Organization encourages the strengthening of rehabilitation care worldwide through the "Call for Action to 2030," emphasizing primary health care (PHC) as a fundamental strategy.

OBJECTIVES

To analyze the temporal and spatial evolution of the rehabilitation workforce in PHC in Brazil and its federative units from 2010 to 2023 and to estimate projections up to 2030.

METHODS

This was an ecological time series and spatial study in which the density of rehabilitation professionals (rate per 10,000 inhabitants) in PHC was projected. Workforce trends and projections were estimated via the SARIMA model; average annual percent change (AAPC) and linear regressions were used to evaluate temporal evolution. The correlation between the Municipal Human Development Index (MHDI) and the workforce was assessed via Moran's I index.

RESULTS

Workforce density in PCH increased between 2010 and 2023 (AAPC 6.21%) but remained low and uneven across professions and regions, with slower growth projected to 2030 (AAPC 4.61%). Persistent regional and professional inequalities were observed, particularly among speech-language pathologists and occupational therapists, with a weak association between workforce density and human development.

CONCLUSIONS

Although the rehabilitation workforce in PHC has expanded in Brazil, projected growth deceleration and persistent territorial inequalities pose challenges to future demand. Strengthening rehabilitation within PHC through integrated workforce and policy strategies is essential to reduce inequities and advance universal health coverage.