Agho and John Human Resources for Health (2017) 15:37 DOI 10.1186/s12960-017-0212-5 RESEARCH Open Access Occupational therapy and physiotherapy education and workforce in Anglophone sub-Saharan Africa countries Augustine O. Agho1 and Emmanuel B. John2* Abstract Background: Sub-Saharan Africa (SSA) countries are faced with the challenge of educating a critical mass of occupational therapists (OTs) and physiotherapists (PTs) to meet the growing demand for health and rehabilitation services. The World Federation of Occupational Therapy (WFOT) and World Confederation of Physical Therapy (WCPT) have argued for the need of graduate-level training for OTs and PTs for decades. However, very few studies have been conducted to determine the availability of OT and PT training programs and practitioners in SSA countries. Methods: Initial data were collected and compiled from an extensive literature search conducted using MEDLINE and PubMed to examine the availability of OT and PT education and training programs in SSA countries. Additional data were collected, compiled, and collated from academic institutions, ministries of health, health professions associations, and licensing authorities in SSA countries. Secondary data were also collected from the websites of organizations such as the World Bank, World Health Organization (WHO), WFOT, and WCPT. Results: This investigation revealed that there are limited number of OT and PT training programs and that these training programs in Anglophone SSA countries are offered at or below the bachelor’s level. More than half of the countries do not have OT or PT training programs. The number of qualified OTs and PTs appears to be insufficient to meet the demand for rehabilitation services. Nigeria and South Africa are the only countries offering post-entry-level masters and doctoral-level training programs in physiotherapy and occupational therapy. Conclusions: Higher learning institutions in SSA countries need to collaborate and partner with other regional and foreign universities to elevate the educational training and increase the supply of PTs and OTs in the region. Keywords: Occupational therapy education, Physiotherapy education, Sub-Saharan Africa, Health workforce Background (SSA) live longer, and its population gets older, the dis- Strategic initiatives and interventions for communicable ease burden has been increasingly defined by chronic diseases in Africa—especially in childhood—by WHO, long-term care diseases and disabilities rather than pre- governments, and non-governmental organizations from mature mortality [4, 7–11]. While mortality and morbid- around the world, have shifted attention to the rise of ity rates attributed to communicable diseases remain chronic non-communicable diseases (NCD) as another high, the prevalence of preventable non-communicable emergent burden [1–6]. As people in sub-Saharan Africa diseases has also increased significantly over the past five decades in countries around the world [3, 7, 8, 12]. According to WHO, 60% of deaths worldwide each year * Correspondence: [email protected] 2Department of Physical Therapy, Chapman University, Irvine, CA, United are attributed to accidents, injuries, and NCD such as States of America coronary heart disease, hypertension, diabetes, stroke, Full list of author information is available at the end of the article © The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Agho and John Human Resources for Health (2017) 15:37 Page 2 of 7 and kidney disease [2]. Unfortunately, perennial short- OT and PT education varies greatly from country to age of the healthcare workforce on the African con- country in SSA. WFOT and WCPT have supported tinent makes tackling chronic diseases and disabilities efforts to increase and improve OT and PT education in resulting from NCD challenging [13]. This is due in sub-Saharan Africa by working with regional and part to continued Africa population growth [10, 11] national professional associations. To the best of our and migration of healthcare professionals to devel- knowledge, few studies have attempted to systematically oped countries [14–16]. examine OT and PT educational programs and the Rehabilitation in many of these non-communicable workforce in SSA [32, 33]. While there is a need to situations can be crucial, and studies reflect a lack of examine the current capacity of all SSA countries to access to such rehabilitation in SSA [17–19]. Access to meet the demands for trained PT and OT, given re- rehabilitation services for individuals with short- and source constraints, data availability, and variation in long-term disabilities is lacking because of the inad- health workforce training systems across the different equate number of qualified rehabilitation healthcare language groupings, this study is only focusing on workforce, i.e., physiotherapists, occupational therapists, Anglophone SSA countries. social workers, mental health counselors, speech thera- pists, and prosthetists and orthoptists [20, 21]. Interest- ingly, most of the studies of the healthcare workforce Methods shortage in SSA have focused primarily on nurses and An extensive literature search of relevant articles pub- physicians [20, 21]. With the increasing number of lished in English Language within the last 10 years people suffering and dying from preventable and treat- wasconductedusingMEDLINEandPubMedtoiden- able NCD and injuries in SSA, it is anticipated that the tify from published papers whether OT and PT edu- demand for qualified allied health professionals who pro- cation and training exists in SSA countries. The vide rehabilitation services will increase [22, 23]. electronic search was conducted between December The unmet need for rehabilitation services can be ad- 2015 and February 2016. The main search terms in- dressed by recognizing physiotherapist (PT) and occupa- clude: physiotherapy, occupational therapy, education, tional therapist (OT) as major providers [19]. Individuals training level (i.e., diploma, bachelor, master, and doc- with movement dysfunction, functional limitations, and toral), PT and OT professional organizations, health various disabilities due to illnesses, disorders, and ampu- workforce, access to rehabilitation services, and tations need the services of competent PT and OT [20]. licensing of PTs and OTs. For more focused search PTs are trained to provide services that develop, main- results, the terms “Africa”,and“Sub-Saharan Africa” tain, and restore an individual’s maximum movement were used with Boolean operators (AND, OR, and and functional ability across the lifespan. Movement dys- NOT). The literature searches were conducted by a function can be a result of aging, injury, diseases, disor- research assistant (GRA), who at the time was a ders, conditions, or environmental factors [24]. Likewise, graduate student in a Master of Occupational Ther- OTs are trained to promote the health and well-being of apy entry-level program, and by one of the authors individuals through the therapeutic use of daily activities who is a physiotherapist. Relevant published papers (occupations). The primary goal of OT is to enable retrieved using the specific search terms were people to participate in the activities of everyday life, reviewed by the authors. The title and abstract of achieving outcomes by working with individuals and relevant papers were first reviewed by the authors in communities to enhance their ability to engage in the order to determine whether full review and data ex- occupations they want to, need to, or are expected to do traction was necessary and appropriate. The GRA and or by modifying the occupation or the environment to the executive assistant to the primary author assisted better support their occupational engagement [25]. In in collecting and compiling secondary data collected studies from developed and some SSA countries, it was from the websites of the following organizations: suggested that it would be advantageous to SSA coun- World Bank, WHO, WFOT, WCPT, Nigeria Physio- tries facing critical shortage of healthcare workers to therapy Network, Occupational Therapy Africa Re- train and deploy OT and PT as mid-level healthcare gional Group, Ghana Association of Physiotherapists, practitioners who might be as effective as physicians for Zambia Association of Physiotherapists, and Health certain services [23, 26–30]. For instance, in South Professionals Council of South Africa. All the collated Africa, physiotherapists are recognized as autonomous secondary data and information obtained from institu- healthcare professionals who can diagnose, treat, and tional websites were verified by seeking the feedback refer patients to medical practitioners and specialists of PT and OT faculty members and key personnel at and order X-ray and other imaging studies, as well as professional licensing/registration boards, professional issue a certificate of illness [23, 31]. associations, etc., located in SSA countries. Agho and John Human