ABSTRACT
The need for neuropsychological rehabilitation services is underscored by the high prevalence of neurological, mental health, developmental and substance use (NMDS) disorders and the growing global public health problems they represent (Whiteford et al., 2015). Neuropsychological rehabilitation science is generally well developed in most high-income countries, as is service delivery, as its importance for the treatment of the cognitive, emotional, behavioural and psychosocial consequences of NMDS disorders is recognised. This is not the case in most low- and middle-income countries (LMICs) where it is still either conspicuously absent or evolving. More than 80 per cent of the world's population lives in these less developed countries (World Bank, 2014) where the health sector is under-resourced, the treatment gap for NMDS disorders is high and their contributions to the burden of disease is disproportionately large (e.g. Whiteford et al., 2015). This burden varies by region and only a small proportion of individuals with these disorders in LMICs receive treatment in specialised or general health-care systems. For instance, China and India comprise 38 per cent of the world's population and report approximately one third (66 million) of the Disability Adjusted Life Years (DALYs) attributable to NMDS. This proportion of the contribution of these disorders to the global burden of disease is greater than in all the developed countries combined (Charlson et al., 2016). This underscores the need for neuropsychological rehabilitation services in these LMICs, where significantly large treatment gaps form part of the larger problem of health sector neglect, which is often considered a violation of the fundamental human right to health (Burns, 2011). Such social justice and human rights issues are compounded by the fact that in many such countries where services do exist they are usually not accessible and/or culturally acceptable to all (e.g. Article 12 of the United Nations International Covenant on Economic, Social and Cultural Rights, www.ohchr.org/EN/ProfessionalInterest/Pages/CESCR.aspx).
