Building PRM in sub-Saharan Africa

Abstract

It is estimated that about 50% of people in low- and middle- income countries who require rehabilitation do not get it. Multidisciplinary rehabilitation services led by Physical and Rehabilitation Medicine (PRM) physicians have been shown to improve functioning, independence and the quality of life of persons with reduced functioning or disability. However, there is a dearth of PRM physicians in low to middle income countries (LMICs), particularly in sub-Saharan Africa. One potential solution to this lack of specialists is the establishment of PRM training programs, which are currently lacking. The International Rehabilitation Forum (IRF) developed and implemented a fellowship program to train physicians in rehabilitation medicine and has been successful in Ghana, Ethiopia and Cameroon, all LMICs in sub-Saharan Africa. However, ongoing challenges include inadequate PRM trainers, availability of logistics and services for hands on experience, and funding. The fellowship program has a promising future and an ultimate goal of having locally trained fellows leading the program and expanding it to other LMICs. There has however been no publication of the process followed to achieve this or of a similar process undertaken anywhere in Africa. The process followed in this publication highlights the journey from engaging stakeholders to the admission of new and current fellows in training.

“Leadership in Rehabilitation Teamwork: Challenges for Developing Countries”

“…Different forms of team work, including interdisciplinary (IDR), multidisciplinary (MDR), and transdisciplinary rehabilitation formats, were described. However, there are disputes about the suitability, effectiveness, and setting of each type of team ( 6 , 7 , 8 , 9 ). The composition of the rehabilitation teams and the number of team members vary widely depending on the disease condition and the individualized choice of the primary team member.…”

“…Effective team management is considered essential for rehabilitation goal setting team meetings and subsequent team coordination. Many of the developing countries' rehabilitation is not a health priority and faces multiple challenges in rehabilitation team functioning ( 9 , 13 , 14 , 15 , 16 ). Then, what should be the format of the rehabilitation team and who should be leading and coordinating the team functions?…”

“…Consequently, one or two physical rehabilitation medicine physicians successfully lead rehabilitation teams in some nations in Asia and the sub-Saharan area. The IRF played a typical neutral catalyst role in transferring rehabilitation leadership thought ( 9 , 16 , 18 ).…”

“…BOX 1 Challenges for leadership role in team functioning [9,13,14,15,16,19,20] • Lack of relevant course contents of the rehabilitation professional curriculum…”