Introduction
Rehabilitation is one of the basic services for the elderly as well as people with disabilities and provides the possibility of participation in the society for these people. In fact, it is one of the main pillars of the health [1]. In old age, people may lose their individual independence to some extent and become dependent in doing their daily living activities. This requires medical and especially rehabilitation services for older people. Rehabilitation provides the possibility of adapting the environment for an elderly person with a disability [2, 3]. Despite the importance of rehabilitation for older people with disability, there are many problems in this field in Iran [5, 6, 7, 8, 9, 10], and few studies have identified the barriers and facilitators of rehabilitation for these people in Iran. Therefore, this study aims to identify the barriers and facilitators of rehabilitation in Iran.

Methods
This is a qualitative study using conventional content analysis method. The study population consists of policy makers and managers in the field of rehabilitation, professors and academic elites active in the field of rehabilitation, as well as people who had experience working in governmental and non-governmental organizations related to rehabilitation in Iran. Of these, 13 participants were selected from different cities of Iran using a purposive sampling method and based on the inclusion criteria. Data were collected through semi-structured in-depth interviews with each participant at their workplace from February 19, 2021 to February 19, 2022. The interview started with an open-ended question, followed by probing questions to clarify the concept. After each interview, the recorded content was carefully transcribed.To analyze the data, Graneheim and Lundman’ method of content analysis was used. To increase the reliability of the data obtained from the interviews, Lincoln and Guba’s criteria (trustworthiness, transformability, dependability, and confirmability) were used.

Results
In general, the findings of the study were presented in two general categories of barriers and facilitators. Barriers and facilitators each had 4 sub-categories (Table 1).


One of the important barriers was the high number of rehabilitation trustees. In fact, the lack of a specific place for rehabilitation in Iran’s health system, paying more attention to the concept of treatment and neglecting the aspect of rehabilitation, and providing services by several organizations can cause problems in implementing rehabilitation programs in the country. Another important barrier was the lack of awareness of the officials, especially those in policy-making and decision-making positions for rehabilitation matters. In this regard, it can be said that the disbelief of the municipal managers regarding the importance of adaptations and not paying attention to the needs of people with disabilities in accessing buildings, public places and transportation vehicles can hinder the rehabilitation programs for older people with disability in Iran. Management problems such as the lack of coordination between the health and rehabilitation systems, the existence of disorganization in rehabilitation matters, the lack of justice in the management of rehabilitation affairs, the neglect of rehabilitation in the health system, and the lack of priority of rehabilitation are among the problems that undermine the rehabilitation in Iran.
Raising awareness and creating culture in the field of rehabilitation and disability was one of the facilitators. Another facilitator was improving the insight of officials, health system specialists and policy makers. Educating officials about rehabilitation, improving their knowledge and informing them about the importance of rehabilitation and prioritizing rehabilitation can have a significant impact on facilitating rehabilitation for older people with disability in Iran. Rehabilitation specialists can play an effective role in introducing their field and role in society, and pursuing and solving major problems they face in their career. Another factor that can help to facilitate and promote the status of rehabilitation was using the experiences of other countries. Communication with other countries in the field of rehabilitation, conducting comparative studies and benefiting from the results of other countries’ studies in the field of rehabilitation, increasing scientific interactions with the world and benefiting from the experiences of successful countries in the field of rehabilitation can have an effective role in improving the status of rehabilitation in the country.

Conclusion
There are many problems and barriers to implementing rehabilitation programs for older people with disability in Iran. Removing these barriers and identifying facilitators is one of the most important health goals for the health system of the country. According to the results of this study, the barriers were: High number of rehabilitation trustees, lack of awareness of officials and people, lack of attention to the role of the municipality in rehabilitation, and poor rehabilitation management. On the other hand, facilitators were: Building culture in the field of rehabilitation and disability, improving the insight of officials, the role of rehabilitation specialists, benefiting from the experiences of other countries. It is necessary for rehabilitation managers and policy makers in Iran to pay attention to these barriers and facilitators and, by raising their awareness and knowledge, fixing managerial deficiencies, considering urban development issues and the accessibility of the elderly and people with disabilities to the facilities, promote the rehabilitation status in the country. Rehabilitation specialists in various fields such as occupational therapy, physiotherapy, geriatric medicine and gerontology can help build culture and introduce rehabilitation in the society by cooperating with each other.

Ethical Considerations
Compliance with ethical guidelines
This study followed all the ethical principles of research, including the confidentiality of information and high-hand documents. It should be noted that this research did not have human participants.

Funding
This article is taken from PhD thesis of Mojgan Farahbod approved by the department of Health Services Management, Islamic Azad University of Research and Science Branch.

Authors' contributions
Conceptualization and study design: Mojgan Farahbod and Iravan Masoudi Asl; Methodology: Mojgan Farahbod, Iravan Masoudi Asl and Mohammad Kamali, Data collection, validation, analysis, research, draft writing, Reviewing, editing and finalizing the article: All Authors.

Conflicts of interest
All authors declared no conflict of interest.


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