Rehabilitation capacity-building in developing countries

Introduction/Background Despite the prevalence of disability in low-and-middle income countries (LMICs), the clinical skills of rehabilitation workforce are not well described. We report health professionals’ perspectives on clinical skills in austere settings and identify context-specific gaps for workforce capacity. Material and method An exploratory-descriptive, cross-sectional, pilot survey of healthcare professionals working in rehabilitation in hospital and community settings conducted in Pakistan, Morocco, Nigeria and Malaysia. A situational-analysis survey-tool captured cross-sectional assessment of clinical skills required in various rehabilitation settings. Participant responses were coded in a line-by-line process, and clustered into common terms based on International Classification of Functioning, Disability and Health (ICF) framework to classify skill-categories in target domains. Results Survey respondents ( n  = 532) from Pakistan 248, Nigeria 159, Morocco 93 and Malaysia 32 completed the survey. The participants were: physiotherapists (52.8%), nurses (8.8%), speech and occupational therapists (8.5%, 5.3%), other medical doctors (5.5%), rehabilitation physicians (3.8%), and prosthetist/orthotists (1.5%). The 10 most commonly used clinical skills reported were prescription of physical activity and medications, transfer-techniques, daily-living activities, allied health interventions, patient/carer education, comprehensive patient-care, diagnosis/screening, behaviour/cognitive interventions, referrals, assessments and collaboration. Most responses linked with ICF categories in activities/participation, and personal factors. Conclusion The survey tool identified task shifting amongst healthcare professionals. The core skills and gaps reflected general rehabilitation practice, rather than discipline-specific skills.