Personnel

To have the capable work force, with the adequate level of education and training, throughout the country is a requisite for a country to be able to warrantee the right to personal mobility to their citizens with mobility impairment.

Workforce planning should take into account all the disciplines required in wheelchair services at all levels [32]: community, integrated in rehabilitation curricula, and continuing education. Stakeholders to be taken into considerationfor this are CBR networks, professional organizations, organizations/ networks of rehabilitation schools, and the Ministry of Health. For example: Colombia has an association of physical therapy schools and an association of occupational therapy schools. Following the publication of the WHO (2008) Guidelines on the Provision of Manual Wheelchairs in Less-resourced Settings [5], WHO, in partnership with the United States Agency for International Development, worked with a network of stakeholders to develop a series of Wheelchair Service Training Packages (WHO WSTP). The main purpose of the training packages is to develop the minimum skills and knowledge required by personnel involved in wheelchair service delivery. There is a Basic level package (WHO WSTPb), Intermediate level package (WHO WSTPi), as well as a two-part package for wheelchair service managers and for stakeholders (WHO WSTPm and WSTPs, respectively) involved in wheelchair provision in any capacity. An important aspect of the WHO WSTPm is the guide for managers to map organizational changes needed to integrate new personnel, reallocate resources, communicate changes in services and coordinate across departments. Further information can be found following links below:

Research evidence suggesting that many formal rehabilitation programs provide limited training in wheelchair provision, highlights the need for additional professional development in this area [48, 49]and delivery of this content in formal curricula. A prerequisite to developing a training curriculum, or related standards (i.e. accreditation and certification), is the identification of service delivery personnel by the Ministry of Health or similar [25]. For this type of strategy to have buy-in it is necessary to involve not only the Ministry of Health by professional organizations (if available). ISWP has also developed the Seating and Mobility Academic Resource Toolkit (SMART) to aid formal education rehabilitation programs to integrate wheelchair provision content. Academic institutions should also be the drivers of research in the wheelchair sector, including training the professionals with research skills [50].

Two examples of accreditation of assistive technology training programs can be highlighted:

  1. The International Society of Prosthetics and Orthotics, in collaboration with WHO, develop an accreditation programfor the different levels of education around the world[51].
  2. The Committee on Accreditation of Allied Health Education Programs in the United States, sponsored by the Rehabilitation Engineering and Assistive Technology Society of North America (RESNA), created the accreditation process for Rehabilitation Engineering and Assistive Technology Education.

Additionally, a strategy to verify that only the suitable personnel are involved in provision is that the policy mandates a certification. For instance, a training pathway that leads to credentialing for wheelchair sector professionals is available from ISWP. Part of this proposed pathway includes knowledge and proficiency tests:

  1. ISWP Wheelchair Provision Basic Level Test: Will require continuing education to maintain certification [52].
  2. ISWP Wheelchair Provision Intermediate Level Test.
  3. ISWP Trainee Competency Assessment for the Training of Trainers [53].

Specific international rehabilitation bodies such as World Confederation for Physical Therapy (WCPT), World Confederation of Occupational Therapists (WFOT), International Society of Physical and Rehabilitation Medicine (ISPRM)can provide guidance for a country related to national credentialing and accreditation. Additionally, continuing education should be an option to maintain the certificate or licensing status. Establishing a continuing education credit system will ensure service professionals keep up to date with advances in clinical practice and technology. The Resources section provides more examples of professional certifications related to assistive technology.