Role of Physiotherapists in Global Health

Original Editor - Laura Ritchie with tremendous gratitude to members of the Global Health Division of the Canadian Physiotherapy Association for assistance with content for this article.

Top Contributors - Naomi O'Reilly, Gayatri Jadav Upadhyay, Kim Jackson, Tony Lowe, Tarina van der Stockt, WikiSysop, Rucha Gadgil and Jess Bell  

Introduction[edit | edit source]

According to the WHO 2011 World Report on Disability, around 15 percent of the global population has some form of disability (i.e. more than 1 billion people). Prevalence of disability is higher in resource-poor countries compared to high-income countries. The global estimate for disability is increasing due to ageing populations, the spread of chronic diseases and improvements in the methodologies used to calculate disability. [1]

There are many ways that physiotherapists can participate in global health work beyond direct patient care, including advocating for and developing rehabilitation programmes (Alappat et al., 2007), as well as continuing to be more involved in the international trend to implement Community Based Rehabilitation (CBR) as a strategy for sustainable and effective development of the health and social sectors.

The question of what skills, knowledge and qualities must physiotherapists possess in order to do ethical and effective global health work remains.

How Do Physiotherapists Fit Into Global Health?[edit | edit source]

GHD photo nepalability4 (1).jpeg

According to Mickan et al (2010), “there is a clear requirement for collaboration among health workers from different professional backgrounds as no one person is able to deliver care to meet the complete needs of the patient.” [2] Collaborative Practice is noted to “[occur] when multiple health workers provide comprehensive services by working together synergistically along with their patients, their families, carers and communities to deliver the highest quality of care across settings.” [2]

Physiotherapists are key members of collaborative inter-professional teams due to their broad scope of practice. As is typical with varying locales, the specific role of a physiotherapist varies according to the needs of the specific population in question. At the First Physical Therapy Summit on Global Health in 2007, the overarching roles of the physiotherapist as an “Agent of Change” and “Health Advocate” were discussed. [3] Some of these roles include:


Members of Inter-disciplinary Health Teams 

  • For the provision of direct service [3] [4] 

Educators and Mentors related to [3] [4]
  • Prevention and management of non-communicable diseases and lifestyle-related conditions (e.g. obesity, diabetes, heart disease). This was a notable priority for all geographic regions represented at the 2007 Summit[3] and has been re-iterated in more recent research[5]
  • Prevention of incidents such as workplace injuries 
  • Increasing physical activity levels - a recent study of Australian adults found that patients expect their physiotherapist to provide physical activity advice,[6] but conversely, another study found that Australian physiotherapists have poor knowledge of the Australian Physical Activity and Sedentary Behaviour guidelines and only infrequently promote physical activity with their patients[7] 
  • Infection control 
  • Maternal and child health

Advocates

  • To establish and/or develop education and healthcare programs that maximize local resources to ensure sustainability.[4] Some recent studies have explored physiotherapists' perception of their ability to engage in health promotion / education, and find variable levels of engagement.[8][9] For example, a recent study of Nigerian physiotherapists has found that while the majority of the physiotherapists had good knowledge, and often used health promotion in their practice, most respondents felt that their entry-level physiotherapy education did not adequately prepare them for health promotion practice.[9]

Screeners

  • Lifestyle Conditions
  • HIV/AIDs
  • Mental Health Conditions
  • For Physical and/or Sexual Abuse [3] 

Referees 

  • Identify conditions that require referral to other health practitioners [3]

Consultants

  • To Urban Planners
  • Government [3] 

Leaders and Active Participants

  • In Health Policy Decision-Making [3] 


[10]

Physiotherapists Role in Global Health Issues[edit | edit source]

Physiopedia Resources of PTs role are given below -

http://www.physio-pedia.com/Tackling_Physical_Inactivity:_A_Resource_for_Raising_Awareness_in_Physiotherapists

http://www.physio-pedia.com/Public_Health_and_Physical_Activity

http://www.physio-pedia.com/Determinants_of_Health

http://www.physio-pedia.com/Barriers_to_Physical_Activity

http://www.physio-pedia.com/Physical_activity_awareness_campaign_in_Mbarara_Municipality

http://www.physio-pedia.com/Non-Communicable_Diseases

http://www.physio-pedia.com/Management_of_Obesity

http://www.physio-pedia.com/Fostering_behaviour_change_in_the_obese_adolescent

http://www.physio-pedia.com/Diabetes

http://www.physio-pedia.com/Malaria

https://www.physio-pedia.com/Tuberculosis

http://www.physio-pedia.com/HIV/AIDS

http://www.physio-pedia.com/Low_Back_Pain_and_Pregnancy

References[edit | edit source]

  1. World Health Organisation. World report on disability: Malta; 2011. 325p.
  2. 2.0 2.1 Mickan S, Hoffman SJ, Nasmith L; World Health Organizations Study Group on Interprofessional Education and Collaborative Practice. Collaborative practice in a global health context: Common themes from developed and developing countries. J of Interprofessional Care. 2010 24(5): 492-502.
  3. 3.0 3.1 3.2 3.3 3.4 3.5 3.6 3.7 The First Physical Therapy Summit on Global Health: Implications and Recommendations for the 21st centuryfckLRPhysiotherapy Theory and Practice: An International Journal of Physiotherapy. 2011; 27(8).
  4. 4.0 4.1 4.2 Alappat C, Siu G, Penfold A, McGovern B, McFarland J, Raman S, Landry MD. Role of Canadian Physical Therapists in Global Health Initiatives: SWOT Analysis. fckLRPhysiotherapy Canada. 2007; 59(4): 272-285.
  5. Naidoo N, Barnes R Mlenzana N, Mostert K, Amosun D. Physiotherapy in rehabilitation and prohabilitation across the lifespan. South African Medical Journal. 2019;109:142-4.
  6. Kunstler B, Fuller R, Pervan S, Merolli M. Australian adults expect physiotherapists to provide physical activity advice: a survey. Journal of Physiotherapy. 2019;65(4):230-6.
  7. Freene N, Cools S, Bissett B. Are we missing opportunities? Physiotherapy and physical activity promotion: a cross-sectional survey. BMC Sports Sci Med Rehabil. 2017;9:19.
  8. Shore H, Hebron C. Musculoskeletal physiotherapists' perceptions of health promotion. Musculoskeletal Science & Practice. 2020;50:102260.
  9. 9.0 9.1 Abaraogu UO, Onah U, Abaraogu OD, Fawole HO, Kalu ME, Seenan CA. Knowledge, Attitudes, and the Practice of Health Promotion among Physiotherapists in Nigeria. Physiother Can. 2019;71(1):92-100.
  10. Global Health Division. Developing sustainable programs in rural India: vlog with Andrea Mendoza. Available from: http://www.youtube.com/watch?v=DrQu9AQXfKg [last accessed 15/05/16]