Evidence map›Paper›PMID 41069591›Full record

ReviewFrontiers in rehabilitation sciences2025

Operationalizing systems thinking approach to sustain public health rehabilitation programs: a rapid review and strategic synthesis.

Zanib Nafees, Mahmoud AboAlfa, Mohammed Alkhaldi

Abstract readReview
In one paragraph

Review in Frontiers in rehabilitation sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Zanib NafeesSchool of Physical & Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Canada.
Mahmoud AboAlfaSchool of Physical & Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Canada.
Mohammed AlkhaldiSchool of Physical & Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Public Health Rehabilitation Programs (PHRPs) are essential to achieving universal health coverage and disability-inclusive health systems. Despite their importance, sustainability is threatened by demographic pressures, funding variability, and weak system integration. Systems Thinking (ST) provides a structured paradigm to address complexity, identify key leverage points, and embed adaptive capabilities for longer-term program survival. Our aim was to summarise global applications of ST in PHRPs and identify mechanisms that most effectively contribute to sustainability. Methods: We conducted a rapid review of peer-reviewed literature and global case studies published between 2010 and 2025. The short timeframe was intentionally selected to provide timely, policy-relevant insights while laying the groundwork for more extensive future reviews. Searches in PubMed, Scopus, and WHO repositories identified studies applying ST to sustain PHRPs. Data were thematically synthesized using the WHO 10-step ST framework and the Systems Thinking for Health (ST4H) model. Results: Six studies from six countries were included. Three mechanisms emerged: (1) Feedback Loops & Adaptive Learning, (2) Stakeholder Engagement & Systems Mapping, and (3) Strategic Leverage Points. Examples from diverse contexts, especially low- and middle-income countries such as Brazil, India, South Africa, and Jordan, demonstrated improved service integration, resilience, and reach. Conclusion: ST offers a robust framework for addressing persistent sustainability challenges in PHRPs. Embedding ST early in program design, supported by cross-sector engagement, systems literacy, and strong governance, enhances adaptability, equity, and efficiency. This rapid review provides actionable evidence for policymakers and practitioners, while also underscoring the need for context-specific sustainability metrics and broader scoping or systematic reviews to deepen and expand the evidence base.

Indexed as

low- and middle-income countriespublic healthrapid reviewrehabilitationsustainabilitysystems thinking

Identifiers

PMID41069591
PMCPMC12504261

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.