Collaborative Occupational Therapy Development in Africa

1. Occupational Therapy African Context Peter Ndaa

2. Rehab professionals acknowledging each other… ….for the sake of service users

3. Occupational therapy

4. Background • Africa is challenged to educate a critical mass of occupational therapists to meet the populations growing demand and need for health and rehabilitation services. • WFOT has urged graduate-level training for OTs for decades. • Need for collaboration among rehabilitation professionals

5. Occupational Therapy Africa Regional Group • The Occupational Therapy Africa Regional Group (OTARG) was formed as the regional representative ofthe World Federation of Occupational Therapists (WFOT) • OTARG include 19 country members.

6. Functions Promote Occupational Therapy in Africa by: • Promoting co-operation amongst OTs and OT Associations; • Professional ethics; • Facilitate regional exchange through placement of OTs and OT Students; • Facilitate the exchange of information and advance the standards of practice in occupational therapyamong other objectives. • Facilitate country/regional collaboration with other professional associations with similar agenda

7. Development of OT programs New OT programmes in decades 2010’s 2000’s 1990’s 1980’s 1970’s 1960’s 1950’s 1940’s 0 1 2 3 4 5

8. 15 African countries with OT education programmes African countries with OT programmes

9. Currently … • 15 of 54 countries in Africa have O T education programs • ALL African OT programs are offered at or below the bachelor’s level Exception: • Most programs in South Africa are at or above bachelor’s level

10. Levels of OT Educational Programs in Africa • 4 Doctoral level (Ph.D.) programs (South Africa) • 5 Master’s level programs • 16 Bachelor degree (BSc) programs • 7 Diploma (3-year) Programs

11. Level of programme offered Dip (8) 8 7 BSc (17) 6 5 MSc (5) 4 3 PhD (4) 2 1 0

12. Ranks of OT educators in Africa Professor (4) 35 30 Aso Prof (4) 25 20 Snr Lecturers (78) 15 10 Lecturers (26 5 0 There are as many educators in S/Africa as in all OT Programmes in Africa

13. Resulting… • Too few OT educational programs in Africa (N = 32) • Most educational programs (72%) are at the diploma or bachelors/degree level • Too few OTs to meet the population needs (approximately 7,453 OTs in Africa for a 1.216 billion people = One (1) OT for 163,156 people ) • The vast majority of OT educators hold the lower ranks in academia

14. Contextual barriers to OT rehabilitation services in Africa • Long distances to health services, • Poor infrastructure, roads, poor access, • Shortage of professionals • Poor economic situations of people • Lack of knowledge about rehabilitation • Lack of locally generated research evidence • Gov’t policies that do not prioritize rehabilitation • Cultural beliefs/stigma

15. Challenges in Uganda • 1 in 5 Ugandan over 5 years old has a disability (Demographic and Health Survey) • In 2014 there were >5.6 million PWD in Uganda (Poverty & Disability in Uganda). • 87 OTs are actively practicing (Uganda Allied Health Council, 2017). • UGANDA: 5,625,000 PWD/87 OTs = 1 OT for every 64,655 PWD • USA: 56,700,000 PWD/111,791 OTs = 1 OT for every 507 PWD

16. Need a concerted effort to… • Increase the number of OT clinicians and educators with advanced degrees • Sustain and develop advanced entry-level OT educational programs at or above the bachelor entry-level

17. Searching for answers • Can we improve the pace to develop OT training programs in Africa as we are not producing enough OT’s to meet the need? • How can we capitalize on our strengths? • What strategies can be used to develop strong inter-regional collaboration to increase capacity of rehabilitation services? • Can inter professional collaboration maximize outcome from our limited resources?

18. Develop policies that promote relevant information gathering for rehabilitation practice in Africa Most regions in Africa lack relevant policies for rehabilitation There is lack of data and statistics thus, inadequate research evidence in rehabilitation to inform policy formulation Most countries lack contextually relevant assessment tools that capture the needs for rehabilitation Inadequate occupational therapy/ Rehab professionals in most Africa countries

19. pndaa@chs.edu.gh OR peepgy@yahoo.com +233 2098 65603

20. References • Occupational therapy and physiotherapy education and workforce in Anglophone sub-Saharan Africa countries. Augustine O. Agho and; Emmanuel B. John Email author. Human Resources for Health201715:37. https://doi.org/10.1186/s12960-017-0212-5. • The world bank. In Population growth in Africa: grasping the scale of the scale of the challenge, vol. May 15, 2016: The World Bank 2013 • WFOT. Definition of occupational therapy. 2012. Available from: [http:www.wfot.org/AboutUs/AboutOccupationalTherapy/DefinitionofOccupatinalTherapy.aspx]. Accessed: 15 May 2016. • Hobbs JA, Boysen JF, McGarry KA, Thompson JM, Nordrum JT. Development of a unique triage system for acute care physical therapy and occupational therapy services: an administrative case report. PhysTher. 2010;90:1519. • Njelesani J, Stevens M, Cleaver S, Mwambwa L, Nixon S. I nternational research partnerships in occupational therapy: a Canadian-Zambian case study. OccupTher Int. 2013;20:78-87. • Alers V, Crouch R. Occupational therapy: an African perspective. Johannesburg, South Africa: Sarah Shorten Publishers; 2010. p. 344 • Said Nafaisaidnafai@otmorocco.org,l’InstitutSupérieurdes Professions Infirmières et Techniques de Santé http://ispits.sante.gov.ma/RABAT/Pages/default.aspx ; Marie Felix mfelix@hi-maghreb.org • Position on occupational therapy bachelor degree education in Uganda, Uganda Association of Occupational Therapy, 2017 • Uganda Bureau of Statistics, 2014