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Holm B.1, Jensen L.S.1, Jacobsen G.B.1, Christensen J.1, Kronborg L.1
1Copenhagen University Hospital, Hvidovre, Department of Physio- and Occupational Therapy, Hvidovre, Denmark
Background: Provision of basic physiotherapy services at Mnazi Mmoja Hospital (MMH), Zanzibar is a constant challenge. Until recently only two physiotherapists were insufficiently covering the treatment of a population of 1.3mio inhabitants. To close the gap between need of physiotherapy treatment and available staff, an education in physiotherapy was established at Zanzibar in 2014 through collaboration between the Danish International Development Assistance and MMH. Practical collaboration between two cultures with huge intermural differences in systems of politics, education, health, economy, religion and perceptions of disease and body awareness is challenging. This led to the question how to develop physiotherapy and establish a local sustainable education course based on staff and institutions with sparse traditions of education and furthermore how to ensure students future employment?
Purpose: The purpose of this explorative development project was
1) to improve and develop physiotherapy services at MMH and
2) to establish and provide continuous support of a physiotherapy education based on local physiotherapy services.
1) to improve and develop physiotherapy services at MMH and
2) to establish and provide continuous support of a physiotherapy education based on local physiotherapy services.
Methods: Practical support was planned for a 3-year period consisting of on-site support from Danish physiotherapists, exchange visit to Denmark for the local education coordinator and provision of basic materials for hospital and education.
Improvement of physiotherapy services was focused at organizing the workflow for treatment of in- and out-patients, development of clinical guidelines for the most common patient groups, and development of systematized, computer-based patient registration.
Support to establish a local education in physiotherapy consisted of assistance to outline curriculum and teaching plans for the 3-year course and teaching assistance to local teachers in development of lectures and teaching skills. Ministry of Health Zanzibar was approached for agreement on governmental employment of the future, locally educated physiotherapists.
Results: A plan for physiotherapy services at the MMH was outlined and continuously developed. Clinical guidelines for the 8 most common patient groups were developed and are used actively at the hospital to guide physiotherapists and students in clinical practice. Computer-based patient registration was developed and has been practiced by local staff during 1½ year.
A curriculum for the Physiotherapy education was outlined and used for 3 groups of students starting yearly since 2014. 21 students were enrolled in 2014, all still following the course timely and projected to graduate in July 2017. The local physiotherapists now independently manage teaching requirements. Agreement was reached with Ministry of Health Zanzibar to open positions for 50 new physiotherapists at Zanzibar.
Conclusion(s): The intercultural collaboration to improve physiotherapy services and establish a local physiotherapy education has been successful. The continuous practical on-site support and intermural understanding of cultures was crucial to obtain the results. The challenges were to establish and implement relevant tools and practice for systematic clinical approach, to calibrate educational criteria with local terms and to unite the combination of teaching traditions, methods and learning criteria in a basic, low cost frame.
Implications: The effort to close the gap between lack of physiotherapists and the need of physiotherapy services at Zanzibar seems fruitful and promising towards sustained improvements within the Zanzibar healthcare system.
Funding acknowledgements: The project was funded by the Danish International Development Assistance (DANIDA), Ministry of Foreign Affairs of Denmark.
Topic: Education: clinical
Ethics approval: Ethics approval was not required.
All authors, affiliations and abstracts have been published as submitted.
