A disability training programme was therefore co-developed with people with disabilities and health professionals and pilot-tested in Uganda.
The Medical Research Council approach was employed to guide the development of the disability training. We conducted an umbrella review to gather relevant literature on disability training for healthcare workers. Six interviews were conducted with international experts to gain insights and perspectives on the topic. Additionally, interviews were undertaken with people with disabilities (n = 27) and healthcare workers (n = 17) in Uganda to understand their experiences and needs. A participatory workshop involved key stakeholders to collaboratively design the training material based on the findings from these data sources. We then piloted the co-developed train-the-trainer course and two disability training courses with 10 trainers (5 people with disabilities and 5 health professionals) and 43 participants selected from 5 health facilities. Data were collected through focus group discussions with trainers and in-depth interviews with trainers and participants (n=27) three months post training. An analysis plan was developed by three researchers (TS, ASS, MA) and reviewed collectively to ensure consistency and comprehensiveness. We followed an inductive approach, with initial coding conducted independently. Thematic analysis was used to categorise and interpret the data, and Kirkpatrick’s Four-Level Training Evaluation Model was applied to structure our findings on reactions, learning, behaviour changes, and results
The training was co-designed to cover disability rights, effective communication, informed consent, and inclusive practices. It was developed to include interactive workshops, case studies, and peer learning and to be delivered in one day by a person with a disability and a healthcare professional. The training emphasised cultural sensitivity and practical skills, with people with disabilities as trainers to foster understanding and improve care quality. Participants reported valuing the trainers' experiences and the combined personal and professional insights. This approach enhanced engagement and credibility. Trainers with disabilities reported feeling empowered and more confident in advocating for inclusive healthcare. At three months post training, participants reported that patient care and clinic accessibility improved, citing examples of improved communication and provision of assistive products. However, policy and resource constraints hindered systemic changes, indicating a need for ongoing support and adjustments.
While some healthcare professionals applied inclusive practices, others faced challenges due to a lack of support and resources. Approaches to develop ongoing mentorship and peer learning should include structured follow-up sessions, regular feedback opportunities, and the creation of support networks to reinforce training concepts and address emerging challenges in disability care
Healthcare professionals, including physiotherapists, require training to effectively address the health concerns of people with disabilities, yet this is rarely included in curricula worldwide. The developed disability training material could be adapted for healthcare professionals in other resource-limited settings, and policy support is needed to ensure its implementation at scale.
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