Changing demographic trends among South African occupational therapists: 2002 to 2018

Abstract

Background: South Africa's quadruple burden of disease, coupled with health system challenges and other factors, predicts a high burden of disability within the population. Human Resources for Health policy and planning need to take account of this challenge. Occupational therapists are part of the health rehabilitation team, and their supply and status in the workforce need to be better understood. Methods: The study was a retrospective record-based review of the Health Professions Council of South Africa database from 2002 to 2018. The data obtained from the Health Professions Council of South Africa was analysed for the following variables: geographical location, population groups, age, practice type and sex. Data was entered on a Microsoft Excel spreadsheet and analysed using the Statistical Package for the Social Sciences (SPSS version 22.0). Results: In 2018, there were 5180 occupational therapists registered with the Health Professions Council of South Africa with a ratio of 0.9 occupational therapists per 10 000 population. There has been an average annual increase of 7.1% over the time period of 2002-2018. The majority of occupational therapists are located in the more densely populated and urbanised provinces, namely Gauteng, Western Cape and KwaZulu-Natal. Most of the registered occupational therapists are under the age of 40 years (67.7%). The majority (66%) are classified as white followed by those classified as black and coloured. Females make up 95% of the registered occupational therapists. Nationally, 74.8% of occupational therapists are deployed in the private sector catering for 16% of the population while approximately 25.2% are employed in the public sector catering for 84% of the population. Conclusions: Under-resourcing and disparities in the profile and distribution of occupational therapy human resources remain an abiding concern which negatively impacts on rehabilitation service provision and equitable health and rehabilitation outcomes.

A Situational Mapping Overview of Training Programmes for Community-Based Rehabilitation Workers in Southern Africa: Strategies for Strengthening Accessible Rural Rehabilitation Practice

“…Additionally, development of a skilled rural workforce through training rural people in rural settings to deliver the services needed in the community is a tenet of rural training pathways (39). Training of CRWs is thus recommended and advocated for, as a cost-effective strategy for developing and scaling up rehabilitation workforce for rural practice (18,23,25). Against this background, a number of points can be drawn from our findings.…”

“…In South African specifically, the discipline-specific training of assistants or technicians were similarly terminated and no Higher Education institution (HEI) has taken up this training (18). A compounding factor is that most NGOs that used to train have discontinued training for CRWs in contexts like South Africa due to lack of support and funding constraints (28,40).…”

“…Consequently, human resource analysis shows higher disability prevalence and higher service demands in contexts with shortages of human resources (11). While many human resource national plans and reviews tend to leave out rehabilitation (2), studies in countries like in South Africa (17)(18)(19), in Malawi (20) and in Kenya, Tanzania and Uganda (9,21) indicate this field and its workforce constraints in less resourced settings (22).…”

'The hand belongs to someone': a therapist perspective on patient compliance

“…The average age of participants was substantially lower than the age of hand therapist reported in the USA 42 . Younger participants were included in the sample given that novice therapists are frequently required to treat hand-injured patients in South Africa 43 and the majority (67.7%) of the South African occupational therapy population is under 40 years of age 44 . Only one of the participants was male and spoke an African home-language.…”

The Perspectives of Males with Serious Mental Disorders on their Community Integration following a Residential-based Rehabilitation Programme in South Africa: "It's a catch-22 situation"

“…Occupational therapy is in essence a systemsorientated health profession 41 . As a scarce human resource and as members of district mental health teams, occupational therapists are therefore positioned to operationalise population-level psychosocial CBR through task-shifting partnerships between MHSUs, community health workers upskilled in psychiatric disability and psychosocial rehabilitation as well as stakeholders in various public sectors 43 .…”