Strengthening capacity for basic hand therapy in South Africa: A consensus development conference and nominal group technique.

Abstract

Introduction: Access to hand therapy is a challenge in low to middle-income countries but is also restricted for many communities in high-income countries. As an essential part of the global rehabilitation community, hand therapists must consider how to extend access to basic hand therapy services and strengthen the capacity of the therapists who provide these services. This study aimed to identify capacity-strengthening strategies for generalist occupational therapists responsible for delivering hand therapy in the South African public health service.

Methods: A consensus development methodology was employed. A hybrid consensus development conference was used to gather local and international evidence pertinent to the project's aim. A panel representing service users (n = 2), service providers (n = 5), research (n = 1), education (n = 1) and professional organisations (n = 5) systematically considered the evidence presented at the conference using a nominal group technique.

Results: The panel identified ten priority areas for action: supervision and support; resources; policy, leadership and governance; education and training; professional knowledge and skill; effective referral and care pathways; data and evidence for service improvement; professional attitudes, behaviours and dispositions; inter- and intra-disciplinary action and cohesion; and an intersectoral systems approach.

Discussion: The priority areas were categorized and are discussed as strategic, educational, organizational, and operational priorities for strengthening the capacity of generalist occupational therapists to deliver quality hand therapy. We suggest ways that both local and global hand therapy communities can take action to position hand therapy as an essential part of universal health coverage.