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Rau B1, Holey L2
1International Committee of the Red Cross, Geneva, Switzerland, 2Freelance International Consultant, Leeds, United Kingdom
Background: In humanitarian and developing contexts physiotherapists have contributed to local clinical services and have trained physiotherapists in clinical skills. Others have contributed more strategically. However, there has not been a study which identifies how to ensure sustainable impact across physiotherapy (PT) as a whole in developing countries for best clinical outcomes.
Purpose: This theoretical paper aims to present a strategic evidence-based model which would enable development of the quality of physiotherapy in a sustainable way in these environments.
Methods: There are three stages to this project. Firstly, the literature was reviewed. Secondly, the results of three pertinent papers were mapped to identify commonaIities. Thirdly, a sustainable model was designed. A search of databases using the EBSCO Discovery interface was undertaken with combined keywords sustainable physiotherapy physical therapy, physiotherapy profession, physiotherapy physical therapy physical rehabilitation international development, humanitarian, developing countries. It identified no articles published between 2008-2018 which focused on sustainable development of physiotherapy.
Results: The literature, including evaluation or impact studies, focuses on either human resources, specific projects, competencies or PT in condition management. However, three studies analyse the current situation relating to the PT profession in an individual country through SWOT analyses - Kuwait (McPherson et al 2013) and India (Khatri and Khan, 2017) and field study - Afghanistan (Wickford et al 2009).. The commonalities found were professional standards, capacity building through education and role of the professional association. These three inter-dependant factors were taken and used to formulate a sustainability triad. 1. Professional standards can be used to re-frame the expectations of PT in a given situation and to build consensus of PT practice with required ressources. They are forward-looking and they have a direct impact on the quality of clinical outcomes. 2. Education at post-qualifying level underpins achievement of the standards through upgrading skills and knowledge of PT clinicians. The pre-qualifying (entry-level) curriculum should ensure that future generations of physiotherapists have the potential to meet the standards on entry to the profession. 3. An effective professional association is essential to safe-guard standards, to advocate and promote and to avoid professional stasis in an evolving healthcare environment.
Conclusion(s): A model has been proposed to aid design of strategic PT projects in developing and humanitarian contexts. It is based on a sustainability triad, a concept widely used in the field of environmental sustainability. It also supports UN sustainable development goals. The three inter-dependant pillars are professional standards, capacity building through pre and post qualifying education and the professional association. A country-wide follow-up study should test and build consensus that the model is appropriate
Implications: It is suggested that strategic initiatives should be planned on this basis and that smaller interventions made to fit within the modeland should also be applied when International development/humanitarian projects are monitored and evaluated. We also recommend that WCPT's involvement in low resourced countries considers this approach in order to secure long-term impact from its support.
Keywords: Sustainability, international development, humanitarian physiotherapy
Funding acknowledgements: No funding was received for this work. ICRC has supported this contribution.
Purpose: This theoretical paper aims to present a strategic evidence-based model which would enable development of the quality of physiotherapy in a sustainable way in these environments.
Methods: There are three stages to this project. Firstly, the literature was reviewed. Secondly, the results of three pertinent papers were mapped to identify commonaIities. Thirdly, a sustainable model was designed. A search of databases using the EBSCO Discovery interface was undertaken with combined keywords sustainable physiotherapy physical therapy, physiotherapy profession, physiotherapy physical therapy physical rehabilitation international development, humanitarian, developing countries. It identified no articles published between 2008-2018 which focused on sustainable development of physiotherapy.
Results: The literature, including evaluation or impact studies, focuses on either human resources, specific projects, competencies or PT in condition management. However, three studies analyse the current situation relating to the PT profession in an individual country through SWOT analyses - Kuwait (McPherson et al 2013) and India (Khatri and Khan, 2017) and field study - Afghanistan (Wickford et al 2009).. The commonalities found were professional standards, capacity building through education and role of the professional association. These three inter-dependant factors were taken and used to formulate a sustainability triad. 1. Professional standards can be used to re-frame the expectations of PT in a given situation and to build consensus of PT practice with required ressources. They are forward-looking and they have a direct impact on the quality of clinical outcomes. 2. Education at post-qualifying level underpins achievement of the standards through upgrading skills and knowledge of PT clinicians. The pre-qualifying (entry-level) curriculum should ensure that future generations of physiotherapists have the potential to meet the standards on entry to the profession. 3. An effective professional association is essential to safe-guard standards, to advocate and promote and to avoid professional stasis in an evolving healthcare environment.
Conclusion(s): A model has been proposed to aid design of strategic PT projects in developing and humanitarian contexts. It is based on a sustainability triad, a concept widely used in the field of environmental sustainability. It also supports UN sustainable development goals. The three inter-dependant pillars are professional standards, capacity building through pre and post qualifying education and the professional association. A country-wide follow-up study should test and build consensus that the model is appropriate
Implications: It is suggested that strategic initiatives should be planned on this basis and that smaller interventions made to fit within the modeland should also be applied when International development/humanitarian projects are monitored and evaluated. We also recommend that WCPT's involvement in low resourced countries considers this approach in order to secure long-term impact from its support.
Keywords: Sustainability, international development, humanitarian physiotherapy
Funding acknowledgements: No funding was received for this work. ICRC has supported this contribution.
Topic: Globalisation: health systems, policies & strategies; Globalisation: health systems, policies & strategies
Ethics approval required: No
Institution: International Committee of the Red Cross (ICRC)
Ethics committee: Cantonal ethical and research commission guidelines Geneva Canton, Switzerland
Reason not required: Literature review. Original data was not collected. All contributors listed as authors
All authors, affiliations and abstracts have been published as submitted.
