REHABILITATION PROFESSIONAL'S TRAINING SCHEMES IN LOW AND MIDDLE INCOME COUNTRIES

Lippolis G.1
1Handicap International, Rehabilitation Unit, Brussels, Belgium

Background: Handicap International is an international organization involved, since more than 30 years, in the promotion of rehabilitation professional's education in low and middle income countries. Different modalities of professional training, including physical therapists, have been promoted ranging from initial formal training, non-standardized training, continuing education training and train the trainers courses.
HI through a collaboration with an external consultancy agency - STEP- carried out a cross cutting evaluation on the outcomes of the training modalities promoted during the last 10 years in 5 different countries.

Purpose: This evaluation took place in order to study the different existing training schemes and the choices made by HI in their implementation, allowing a deep comparative analysis of the practices. The results of this evaluation aim at positioning HI practices in the light of the established training schemes' effects.

Methods: This evaluation focused on the diverse training schemes mainly promoted by Handicap International (accredited or non-accredited initial education, continuous education, training of trainers) in 5 countries (Haiti, Rwanda, Burundi, DRCongo and China) and analysed them based on the OCDE criteria’s (relevance, efficiency, effectiveness, impact and durability). To do so the evaluators (8 in total) developed an analysis referral (with a series of common questions) based on the ISO 29990 standards. This referral was completed based on documentary analysis, interviews of previous rehabilitation professionals and implementing partners.

Results: 1. The modality of training scoring higher was the one based on the direct involvement of HI in setting up continuing education actions. The one with the lower score was the formal training schemes in partnership with accredited bodies. 2. Continuing education rapidly improves the access and quality of rehab services and should be promoted for short terms actions (1 to 2 years actions); 3. Strengthening human resources in the rehabilitation sector can be contemplated in crisis and post-crisis, the strategy is then to train as many and as fast as possible an intermediate level of competences. In this case a phase of monitoring and accompaniment of trainees would be coherent with the notion of intermediary training and middle term results (min 3 years project); 4. When possible to develop a long term results (6-10 years project), strengthening human resources in the rehabilitation sector should be seek by collaboration with qualified and renewed contractors or technical and academic training bodies such as universities or professional associations.

Conclusion(s): Most of international agencies involved in the rehabilitation sector are involved in professional education. The role of international NGO’s can vary and should be defined based on the modality of training promoted, the context of interventions analysis (answer of emergency needs, existence of accreditation mechanisms, employability,…) and the duration of the project.

Implications: The result of this evaluation will be used to develop an HI policy paper on training rehabilitation professionals. In addition an analysis table will be develop in order for HI and its partners to assess before, during and after the training the elements which may enhance the performance of the different training scheme.

Funding acknowledgements: This evaluation and related education projects were fully funded by Handicap International trough the Development Belgian Cooperation (DGD).

Topic: Education

Ethics approval: Ethics approval for the use of data was obtained from the STEP consulting as well as rehabilitation centre staff.


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