Abstract
In 2018, the United Nations global report showed that people with disabilities, who make up 15% of the worlds' population, have poorer health and rehabilitation access (SDG 3). Without improving the needed person-centered health and rehabilitation services at household level, SDG 3 cannot be achieved. This includes addressing human resource shortages through training multi-skilled community based rehabilitation workers (CRWs) to build rural workforce capacity and enhance the lives of people with disabilities, particularly in LMICs where the need is higher but resources are lower. However, to date, there is no documentation and analysis of existing training and its scope for this workforce in LMICs. A situational mapping overview was undertaken to review the current status of rural rehabilitation training programs offered in Southern Africa for CRWs. CRWs are rehabilitation personnel, based in the home/community, who are not professionals (without a bachelor qualification) but render non-institutional rehabilitation and inclusive development in communities, under the supervision of rehabilitation practitioners. Information on these programs was obtained using a two-step process. Firstly, a descriptive list of university courses for rehabilitation workers offered in the Southern African countries was collected via an internet and literature search. Secondly, detailed information about the disability and rural rehabilitation courses was collected from the respective institutions and their designated websites. There are six training courses targeted at CRWs or disability practitioners with a disability focus being offered at universities in Southern Africa, five of these in South Africa and one in Zimbabwe. Additionally, four training courses are offered as online/open resources by global organizations and are self-directed with no accreditation. While other key competencies feature, none of these programmes' learning outcomes make direct reference to the rural practice context and its complexities in relation to disability and poverty. The situational mapping overview shows limited training targeted at CRWs in Southern Africa, to effectively facilitate rural rehabilitation, poverty reduction and social inclusion. There is a need for an articulated community-orientated rural training to respond to the unmet needs. This may require a different set of competencies and assessment standards for trainees as well as additional competencies for their supervisors and mentors.
Highlights
In the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD), disability is defined as “those who have long-term physical, mental, intellectual or sensory impairments which in interaction with various barriers may hinder their full and effective participation in society on an equal basis with others” [1]
The aim of this study was to conduct a situational mapping overview of the current status of training offered for community based rehabilitation workers in Southern Africa, with a particular focus on advocating for training that capacitates communitybased rehabilitation workers (CRWs)’ understanding of CBR and skills to effectively carry put their roles in response to the needs of people with disabilities in rural contexts
The training of rehabilitation practitioners/professionals who will be responsible for supervision of CRWs needs to equip these practitioners with critical reflexivity skills, within a rural context, if they are to contribute to developing their practice. Based on this situational mapping overview, there is a need for an articulated process to develop community-based training of CRWs who will address the unmet rehabilitation needs in rural contexts of Southern Africa
Summary
In the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD), disability is defined as “those who have long-term physical, mental, intellectual or sensory impairments which in interaction with various barriers may hinder their full and effective participation in society on an equal basis with others” [1]. Consistent with literature, the demand and need for rehabilitation is much higher than what can be provided by available services in low- and lower-middle-income countries (LMICs) [11]. This is compounded by a low density of well-trained rehabilitation practitioners required for the delivery of adequate services [12,13,14]. While five of the programmes are located in South Africa, they are accepting South African students but international students Compounding this issue is the major challenge that Universities often do not recognize certificate programs, as career pathways for CWRs [36] they are few. This policy decision could be the reason as to why universities have been slow in investing on this level of training
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