Perspectives on Disability and Non-Communicable Diseases in Low- and Middle-Income Countries, with a Focus on Stroke and Dementia.

Non-communicable diseases (NCD) and disability are both common, and increasing in magnitude, as a result of population ageing and a shift in disease burden towards chronic conditions. Moreover, disability and NCDs are strongly linked in a two-way association. People living with NCDs may develop impairments, which can cause activity limitations and participation restriction in the absence of supportive personal and environmental factors. In other words, NCDs may lead to disabilities. At the same time, people with disabilities are more vulnerable to NCDs, because of their underlying health condition, and vulnerability to poverty and exclusion from healthcare services. NCD programmes must expand their focus beyond prevention and treatment to incorporate rehabilitation for people living with NCDs, in order to maximize their functioning and well-being. Additionally, access to healthcare needs to be improved for people with disabilities so that they can secure their right to preventive, curative and rehabilitation services. These changes may require new innovations to overcome existing gaps in healthcare capacity, such as an increasing role for mobile technology and task-sharing. This perspective paper discusses these issues, using a particular focus on stroke and dementia in order to clarify these relationships.