Ned Lieketseng, Tiwari Ritika, Hess-April Lucia, Lorenzo Theresa, Chikte Usuf
Centre for Rehabilitation Studies, Department of Global Health, Stellenbosch University, Cape Town, South Africa.
Division of Health Systems and Public Health, Department of Global Health, Stellenbosch University, Cape Town, South Africa.
Front Public Health. 2020 Nov 3;8:569279. doi: 10.3389/fpubh.2020.569279. eCollection 2020.
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.
2018年,联合国全球报告显示,占世界人口15%的残疾人健康状况更差,获得康复服务的机会更少(可持续发展目标3)。如果不在家庭层面改善以需求者为中心的健康和康复服务,就无法实现可持续发展目标3。这包括通过培训具备多种技能的社区康复工作者来解决人力资源短缺问题,以建设农村劳动力能力,改善残疾人的生活,特别是在需求较高但资源较少的低收入和中等收入国家。然而,迄今为止,在低收入和中等收入国家,尚无关于这支劳动力队伍现有培训及其范围的记录和分析。开展了一次情况映射概述,以审查南部非洲为社区康复工作者提供的农村康复培训项目的现状。社区康复工作者是在家庭/社区工作的康复人员,他们不是专业人员(没有学士学位),但在康复从业人员的监督下,在社区提供非机构性康复和包容性发展服务。关于这些项目的信息通过两步过程获得。首先,通过互联网和文献搜索,收集了南部非洲国家为康复工作者提供的大学课程描述清单。其次,从各机构及其指定网站收集了有关残疾和农村康复课程的详细信息。南部非洲的大学提供了六门针对社区康复工作者或残疾从业者且以残疾为重点的培训课程,其中五门在南非,一门在津巴布韦。此外,全球组织提供了四门培训课程作为在线/开放资源,这些课程是自主学习的,没有认证。虽然其他关键能力也有体现,但这些项目的学习成果均未直接提及农村实践背景及其与残疾和贫困相关的复杂性。情况映射概述显示,南部非洲针对社区康复工作者的培训有限,无法有效促进农村康复、减贫和社会包容。需要开展明确的以社区为导向的农村培训,以满足未得到满足的需求。这可能需要为受训人员制定一套不同的能力和评估标准,以及为其监督人员和指导人员制定额外的能力标准。