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Table of Contents
Year : 2022  |  Volume : 4  |  Issue : 2  |  Page : 90-91

Competency building in physiotherapy: Health care in India

Department of Neuroscience, AIIMS, New Delhi, India

Date of Submission08-Dec-2022
Date of Decision10-Dec-2022
Date of Acceptance16-Dec-2022
Date of Web Publication19-Jan-2023

Correspondence Address:
Mr. Harpreet Singh Sachdev
Department of Neuroscience, AIIMS, New Delhi
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijptr.ijptr_183_22

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How to cite this article:
Sachdev HS. Competency building in physiotherapy: Health care in India. Indian J Phys Ther Res 2022;4:90-1

How to cite this URL:
Sachdev HS. Competency building in physiotherapy: Health care in India. Indian J Phys Ther Res [serial online] 2022 [cited 2023 Jun 6];4:90-1. Available from: https://www.ijptr.org/text.asp?2022/4/2/90/368050

In India, as per the 2019 census, out of a total population of 1.39 billion, approximately 16% were classified with severe disabilities. During 2011–2019, there was a substantial increase in the number of disabled persons in both the rural and the urban population. In developing countries, it is estimated that just 2%–3% of the people with rehabilitation needs benefit from rehabilitation services. There is a substantial and ever-increasing deficiency in accessible rehabilitation services, particularly in low- and middle-income countries (LMIC). The availability of accessible and affordable rehabilitation is important for this population to participate in education, be economically productive, and fulfill meaningful social life roles.[1]

Preventing and managing physical disability in India have many challenges. High rates of poverty, poor education standards and literacy levels, and the lack of health insurance have resulted in reduced access to short- and long-term health care, particularly institutional-based facilities, as and when required. Patients are predominantly discharged to home (community) with only family members to cater to their medical and rehabilitation needs. A relatively small health-care workforce is available per population in most LMIC, including India. The most obvious result of this lack of trained health-care workforce catering to a huge population is in a compromised quality of care. Furthermore, there is a huge lack of organized community support networks and groups.[2] In our aim for universal health coverage, there is a need to explore the opportunities for adding and improving the health-care workforce.

The problems in Indian health care, especially community care of individuals with chronic illnesses and special needs is exaggerated by critical barriers such as lack of adequately trained workforce and infrastructure. The workforce involved in community care needs special attention as additional infrastructure would be of no benefit if the care is not of adequate standards. Health care with a limited budget, especially in LMIC, faces challenges in maintaining and ensuring adequate health-care service delivery.

Interdisciplinary rehabilitation is the foundation of community health, and one of the key disciplines within is physiotherapy, which is primarily aimed at restoring and maintaining activities of daily livings. In large rehabilitation centers and acute care hospitals, physiotherapists are a part of the rehabilitation team, but for a larger population in the community, they may be the only health-care providers available.[2],[3],[4]

Currently, the education curriculum and clinical practice offer inadequate community experiences and relevant training programs for effective community work. Delivering a high-quality professional service is a commitment of every professional. In the absence of defined competency standards, adequate training, lack of incentives, and the need for continuing competence building for physiotherapists in India. Often the community health care and rehabilitation are left neglected, thereby giving rise to the need for creating a model and a system for competency building in physiotherapy.

In India, the education standards and curriculum for physiotherapy are not uniform across the country. Physiotherapists with different skill sets and knowledge practices, even within the same geographical region, provide a very dissimilar set of services. Physiotherapists in India, in most work environments, enjoy autonomy in clinical practice with regard to the type and amount of therapy given. Therapy is determined more by necessity and experience than by basic training or evidence.

The education and training of physiotherapists are of paramount importance in addressing skill imbalances and improving competency levels. Training programs should be geared toward enhancing clinician skills and solving challenges that are presented due to the lack of availability of trained personnel. A specialized training to physiotherapy clinicians delivered by national and international experts directed toward increasing the competency of the physiotherapy workforce in hospitals and the community needs to be first tested and then implemented on a large scale.[5],[6]

Broad research evidence suggests that poor quality and disparities in the delivery of rehabilitation and physiotherapy services result in poor functional outcomes, increased disability, and consequently, a poor quality of life.

In order to achieve the rehabilitation goals of the country, a skilled, competent physiotherapy workforce is of utmost importance. It is, thus, important to address, in an ongoing manner, the competencies of physiotherapy clinicians delivering services to the population to gain the maximum health outcomes, reduce the overall level of disability, and improve the general quality of life. There exists little literature about the specific use of competency-based education in physiotherapy education – “this needs to change.“

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Conflicts of interest

There are no conflicts of interest.

  References Top

Sitora's Story: Building a Better Future for People with Disability. World Health Organization. Available from: https://www.who.int/news-room/feature-stories/detail/sitora-s-story-building-a-better-future-for-people-with-disability. [Last accessed on 2022 Oct 05].  Back to cited text no. 1
Kumar R. Revitalize primary health care for confronting current public health challenges. Indian J Community Med 2008;33:1-2.  Back to cited text no. 2
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Kamalakannan S, Gudlavalleti Venkata M, Prost A, Natarajan S, Pant H, Chitalurri N, et al. Rehabilitation needs of stroke survivors after discharge from hospital in India. Arch Phys Med Rehabil 2016;97:1526-32.e9.  Back to cited text no. 3
Tsering D, Pal R, Dasgupta A. Tobacco use among high school students of West Bengal, India. Indian J Community Med 2008;33:207-8.  Back to cited text no. 4
[PUBMED]  [Full text]  
Furlan AD, Irvin E, Munhall C, Giraldo-Prieto M, Fullerton L, McMaster R, et al. Rehabilitation service models for people with physical and/or mental disability living in low and middle-income countries: A systematic review. J Rehabil Med 2018;50:487-98.  Back to cited text no. 5
Clarke DJ, Burton LJ, Tyson SF, Rodgers H, Drummond A, Palmer R, et al. Why do stroke survivors not receive recommended amounts of active therapy? Findings from the ReAcT study, a mixed-methods case-study evaluation in eight stroke units. Clin Rehabil 2018;32:1119-32.  Back to cited text no. 6


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