Rehabilitation in Conflict: A Conceptual Framework for the Rehabilitation Sector in Fragile Settings

Rehabilitation is an essential component of health systems. Yet in fragile, conflict-affected settings it remains neglected despite growing needs. Fragmented governance, disrupted health systems, and political instability hamper sector development. Existing frameworks, including the World Health Organization health system building blocks, the International Classification of Functioning, Disability and Health, and operational tools such as Systematic Assessment of Rehabilitation Situation or Emergency Rehabilitation Standards, provide valuable global guidance. However, they are less suited to capture the systemic, cross-sectoral, and contextual complexity of rehabilitation in conflict. This Special Communication introduces the "Rehabilitation in Conflict" (RiC) framework-a conceptual model explicitly designed to support analysis and strengthening of rehabilitation in conflict-affected settings. Developed through a 6-step process combining literature review, field-based research, and stakeholder engagement, the framework consists of 4 interdependent components: Context, Systems, Population, and Services. The RiC framework's novelty lies in its sector-wide perspective: it bridges health, social, political, and humanitarian systems, highlights their dynamic and multidirectional interactions, and positions rehabilitation within the broader realities of conflict. In doing so, the RiC framework fills a critical gap and responds to an urgent need for conceptual clarity to inform rehabilitation planning, assessment, and coordination and strengthening. It is particularly relevant for clinicians, researchers, and policymakers working in global rehabilitation, humanitarian response, and postconflict recovery. By offering a structured yet flexible approach, the framework invites debate, further adaptation, and application across diverse fragile settings.