Building the capacity of wheelchair service providers in the state of Sao Paulo, Brazil

Introduction/Background In 2014, when launching the Wheelchair Service Training Package (WSTP) in Portuguese, the three first trainers of the Physical and Rehabilitation Medicine Institute (IMREA) of the University of Sao Paulo Medical School General Hospital trained 20 trainers from Brazil, Mozambique, Cape Verde, Angola, Guinea Bissau and East Timor. After training the staff of IMREA and taking part in the WSTP Training of Trainers in 2016, the Institute expanded WSTP training to facilities in the countryside through the Lucy Montoro Rehabilitation Network, thus decentralizing wheelchair service provision according to the WHO Guidelines on the Provision of Manual Wheelchairs in Less Resourced Settings. This Network is a State-level program that delivers comprehensive rehabilitation services and provides assistive products to persons with physical disabilities in the State of Sao Paulo through the universal Brazilian Public Healthcare System. The study analyses the educational process that built the capacity of 180 rehabilitation professionals. Material and method Based on WHO's WSTP modules (basic, intermediate and manager's), a cascade strategy was used to train 7 core teams of trainers from different rehabilitation facilities and expand it to 180 rehabilitation professionals in 11 facilities. The analysis of the educational process used a structured satisfaction questionnaire and a knowledge evaluation. Results The project trained 180 professionals and created 11 wheelchair clinics abiding by the WHO Wheelchair Guidelines. 97% professionals were approved. 98.48% trainees acknowledged the training offered new knowledge (even though they were all experienced health and rehabilitation professionals) and 89.39% rated it as very good or excellent. Trainees indicated it would result in changes to their daily practice (64%) and behaviour (18%). Conclusion The cascade strategy based on WSTP was successful at building the capacity of rehabilitation professionals about the WHO Wheelchair Guidelines and decentralizing wheelchair service provision.