Narain S1, Mathye D2
1Sefako Makgatho Health Sciences University, Pretoria, South Africa, 2Sefako Makgatho Health Sciences University, Physiotherapy, Pretoria, South Africa
Background: While physiotherapists play an important role in the prevention and treatment of musculoskeletal conditions, and the chronic diseases of lifestyle, in South Africa, doctors and nurses are the key role players in primary health care (PHC) (Premji & Hatfield, 2016). South Africa has a population of 56.5-million people (Brand South Africa, 2017) and there are approximately 7473 physiotherapists registered with the HPCSA (HPCSA, 2017). The unequal workforce distribution along rural-urban lines and the private-public divide compounded with physiotherapy roles being more curative rather than health promotion and prevention creates major challenges for physiotherapy service delivery in PHC.
Purpose: South Africa's health policy documents indicate a persistent marginalisation of physiotherapy from PHC (DOH, 2015). There are enormous benefits for delivering physiotherapy services in PHC and as such this study explores the various strategies to integrating physiotherapy at all levels of PHC. Strategy is defined as a plan of action designed to achieve a long-term or overall aim (https://en.oxforddictionaries.com/definition/strategy).
Methods: A qualitative, exploratory and descriptive approach was used. Data were collected from purposively selected expert physiotherapists who:
(1) were registered with the HPCSA,
(2) had a PhD in Physiotherapy or related fields and
(3) were working at a South African university as an academic.
Nine expert physiotherapists participated in telephonic and Skype semi-structured interviews. Data were transcribed verbatim and analysed using an inductive approach to generate codes and themes.
Results: The participants identified the following six strategies to integrate physiotherapy in PHC in South Africa:
(1) to increase physiotherapy workforce,
(2) to eradicate professional hierarchy
(3) to broaden the role of physiotherapy,
(4) to ensure that physiotherapy is represented in policy documents,
(5) to improve accessibility to physiotherapy services at PHC level and
(6) to transform physiotherapy education.
Conclusion(s): Several strategies are required to ensure optimal physiotherapy service delivery in South Africa. Transformation at an organisation level is essential to define the role of physiotherapy in PHC and the eradication of professional hierarchies will ensure physiotherapy's autonomy in PHC. Physiotherapy associations should be held accountable for timeously representing and advocating for physiotherapists in PHC policies.
A certificate of need should be instituted to address the urban-rural and private-public divides and the demographic profile of physiotherapists can be balanced by supporting the entrance of more males into the profession. Human resources for PHC can be further strengthened by offering public sector RWOPs approval and facilitating a private-public partnership.
The minimal standards for physiotherapists to be licenced with the HPCSA must include PHC, health promotion and prevention, community development and addressing societal needs of the country. Formal training packages can be offered to appraise the knowledge and skills of inexperienced physiotherapists.
Implications: The results of this study will have a positive impact on several levels: health policy, custodians of physiotherapy, undergraduate physiotherapy training, post-graduate training, and clinical practice and provoke a complete overhaul of the profession at an institution level.
Keywords: Physiotherapy, Primary health care
Funding acknowledgements: The study received funding from the National Research Foundation (NRF)
Purpose: South Africa's health policy documents indicate a persistent marginalisation of physiotherapy from PHC (DOH, 2015). There are enormous benefits for delivering physiotherapy services in PHC and as such this study explores the various strategies to integrating physiotherapy at all levels of PHC. Strategy is defined as a plan of action designed to achieve a long-term or overall aim (https://en.oxforddictionaries.com/definition/strategy).
Methods: A qualitative, exploratory and descriptive approach was used. Data were collected from purposively selected expert physiotherapists who:
(1) were registered with the HPCSA,
(2) had a PhD in Physiotherapy or related fields and
(3) were working at a South African university as an academic.
Nine expert physiotherapists participated in telephonic and Skype semi-structured interviews. Data were transcribed verbatim and analysed using an inductive approach to generate codes and themes.
Results: The participants identified the following six strategies to integrate physiotherapy in PHC in South Africa:
(1) to increase physiotherapy workforce,
(2) to eradicate professional hierarchy
(3) to broaden the role of physiotherapy,
(4) to ensure that physiotherapy is represented in policy documents,
(5) to improve accessibility to physiotherapy services at PHC level and
(6) to transform physiotherapy education.
Conclusion(s): Several strategies are required to ensure optimal physiotherapy service delivery in South Africa. Transformation at an organisation level is essential to define the role of physiotherapy in PHC and the eradication of professional hierarchies will ensure physiotherapy's autonomy in PHC. Physiotherapy associations should be held accountable for timeously representing and advocating for physiotherapists in PHC policies.
A certificate of need should be instituted to address the urban-rural and private-public divides and the demographic profile of physiotherapists can be balanced by supporting the entrance of more males into the profession. Human resources for PHC can be further strengthened by offering public sector RWOPs approval and facilitating a private-public partnership.
The minimal standards for physiotherapists to be licenced with the HPCSA must include PHC, health promotion and prevention, community development and addressing societal needs of the country. Formal training packages can be offered to appraise the knowledge and skills of inexperienced physiotherapists.
Implications: The results of this study will have a positive impact on several levels: health policy, custodians of physiotherapy, undergraduate physiotherapy training, post-graduate training, and clinical practice and provoke a complete overhaul of the profession at an institution level.
Keywords: Physiotherapy, Primary health care
Funding acknowledgements: The study received funding from the National Research Foundation (NRF)
Topic: Primary health care
Ethics approval required: Yes
Institution: Sefako Makgatho Health Sciences University
Ethics committee: Sefako Makgatho Health Sciences University Research and Ethics Committee
Ethics number: SMUREC/H/178/2016: PG
All authors, affiliations and abstracts have been published as submitted.
