PHYSIOTHERAPY RESPONSE TO THE HIV PANDEMIC: COMPARISON OF 3 PHYSIOTHERAPY CURRICULA IN EAST AND SOUTHERN AFRICA

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Myezwa H1, Nkandu E2, Konje E3, Omoroh, F3, Potterton J1, Okidi C4, Nixon S5, Solomon P6, Salbach N5, Yates T7, Cameron C8
1University of Witwatersrand, Physiotherapy, Johannesburg, South Africa, 2University of Zambia, Physiotherapy, Lusaka, Zambia, 3Kenya Medical Training College, Physiotherapy, Nairobi, Kenya, 4Kenya Medical Training College, Disability, Nairobi, Kenya, 5University of Toronto, Physiotherapy, Toronto, Canada, 6McMaster University, Physiotherapy, Hamilton, Canada, 7REALIZE, Toronto, Canada, 8International Centre for Disability and Rehabilitation, Physiotherapy, Toronto, Canada

Background: Expanded access to antiretroviral therapy for adults and children living with HIV in sub-Saharan Africa (SSA) has led to new care gaps for people living with HIV as a chronic illness. To date, rehabilitation has been underrepresented in the HIV response partly due to the limited inclusion of HIV within physiotherapy (PT) curricula resulting in a lack of confidence and action in the clinical space.

Purpose: To describe the inclusion of HIV within three diverse physiotherapy programmes in East and Southern Africa.

Methods: A desk review was conducted of the current curricular structure related to HIV within physiotherapy programs at the University of the Witwatersrand, South Africa; the University of Zambia, Zambia; and, Kenya Medical Training College, Homa Bay, Kenya.

Results: At the University of the Witwatersrand HIV is mainstreamed in every aspect of the physiotherapy curriculum starting in first year where the basic tenets of HIV are taught. As students progress in second year, concepts of HIV and rehabilitation are introduced within the practical application of PT techniques, principles and through the use of 12 self-directed learning and research topics. In years three and four HIV is mainstreamed within clinical sciences, physiotherapy and rehabilitation in six clinical blocks. In these years, students also conduct 12 self-directed verbal case presentations. At Kenya Medical Training College a harmonized HIV, AIDS and STI module is taught as one, 32-hour module to first year students. The curriculum is taught concurrently to PT and Clinical Medicine students offering an opportunity for interprofessional education in Homa Bay Campus. There is less focus on the specific role of rehabilitation in the HIV response. Clinical placements begin in the first year, second semester. Curriculum is primarily didactic lectures with cases used during exams. At the University of Zambia the PT program begins in year two with HIV taught within a health promotion course. In years three and four HIV is taught through Pathology and within eight teaching blocks within clinical sciences. Clinical rotations begin in year four. An important outcome of this collaboration, with other international partners in Canada, has been the development and use of an open access SSA HIV and rehabilitation resource (ssa.hivandrehab.ca) with potential for future growth and sustainability

Conclusion(s): The three sites have demonstrated how curriculum related to HIV has been adapted to reflect the diverse curricular structures, pedagogy, use of technology, and resources at each site. To date no specific learning outcome related to impact of HIV inclusion and translation has been assessed and this gap needs to be addressed. Through collaborative efforts, the three sites recommend building upon their respective curricula to develop a novel intervention to improve knowledge, attitudes, and self-efficacy in HIV and rehabilitation advocacy among PT students.

Implications: An open access, adaptable HIV Knowledge Translation intervention will be developed for future scale up to other rehabilitation programmes in sub-Saharan Africa. Strengthening the capacity and integration of HIV rehabilitation in the training of professionals may improve function, ability, and wellness as people live their lives with HIV.

Keywords: HIV, students curriculum, education

Funding acknowledgements: Project funded by Canadian Institutes of Health Research (#153167)

Topic: Oncology, HIV & palliative care; Education

Ethics approval required: Yes
Institution: University of Toronto, Zambia and Witwatersrand and KMTC
Ethics committee: Toronto (#35374); Zambia (#20180409003);
Ethics number: Wits (#M1805504); (KMTC/ADM/74/VOL.IV/)


All authors, affiliations and abstracts have been published as submitted.

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