Skip to main content
Top
Published in: Human Resources for Health 1/2021

Open Access 01-12-2021 | Review

Regulation of the global orthotist/prosthetist workforce, and what we might learn from allied health professions with international-level regulatory support: a narrative review

Authors: Leigh Clarke, Louise Puli, Emily Ridgewell, Michael P. Dillon, Sarah Anderson

Published in: Human Resources for Health | Issue 1/2021

Login to get access

Abstract

Background

By 2050, the global demand for orthotic and prosthetic services is expected to double. Unfortunately, the orthotic/prosthetic workforce is not well placed to meet this growing demand. Strengthening the regulation of orthotist/prosthetists will be key to meeting future workforce demands, however little is known about the extent of orthotist/prosthetist regulation nor the mechanisms through which regulation could best be strengthened. Fortunately, a number of allied health professions have international-level regulatory support that may serve as a model to strengthen regulation of the orthotic/prosthetic profession.
The aims of this study were to describe the national-level regulation of orthotist/prosthetists globally, and the international-level regulatory support provided to allied health professions.

Method

Two environmental scans benchmarked the national-level regulation of the orthotist/prosthetist workforce, and the regulatory support provided by international allied health professional bodies using a set of nine core practitioner standards (core standards) including: Minimum Training/Education, Entry-level Competency Standards, Scope of Practice, Code of Conduct and/or Ethics, Course Accreditation, Continuing Professional Development, Language Standard, Recency of Practice, and Return-to-Practice. Each identified country was categorised by income status (i.e. High-, Upper-Middle-, Lower-Middle-, and Low-Income countries).

Results

Some degree of regulation of the orthotist/prosthetist workforce was identified in 30 (15%) of the world’s 197 countries. All core standards were present in 6 of these countries. Countries of higher economic status had more core standards in place than countries of lower economic status. International-level professional bodies were identified for 14 of 20 allied health professions. International bodies for the physical therapy (8 core standards) and occupational therapy (5 core standards) professions provided regulatory support to help national associations meet most of the core standards.

Conclusion

Given the small proportion of countries that have national practitioner regulatory standards in place, most orthotist/prosthetists are working under little-to-no regulation. This presents an opportunity to develop rigorous national-level regulation that can support workforce growth to meet future workforce demands. Given the financial and expertise barriers that hinder the development of a more regulated orthotist/prosthetist workforce, particularly for Low- and Lower-Middle-Income countries, we recommend the establishment of an international professional body with the express purpose to support national-level regulation of orthotist/prosthetists, and thereby build the regulatory capacity of national orthotic/prosthetic associations.
Literature
2.
go back to reference World Health Organization. WHO standards for prosthetics and orthotics (Part 1). Report no. 9241512482, Genva: World Health Organization; 2017. World Health Organization. WHO standards for prosthetics and orthotics (Part 1). Report no. 9241512482, Genva: World Health Organization; 2017.
5.
go back to reference Gupta N, Castillo-Laborde C, Landry MD. Health-related rehabilitation services: assessing the global supply of and need for human resources. BMC Health Serv Res. 2011;11:276.CrossRef Gupta N, Castillo-Laborde C, Landry MD. Health-related rehabilitation services: assessing the global supply of and need for human resources. BMC Health Serv Res. 2011;11:276.CrossRef
6.
go back to reference McSweeney E, Gowran RJ. Wheelchair service provision education and training in low and lower middle income countries: a scoping review. Disabil Rehabil Assist Technol. 2019;14:33–45.CrossRef McSweeney E, Gowran RJ. Wheelchair service provision education and training in low and lower middle income countries: a scoping review. Disabil Rehabil Assist Technol. 2019;14:33–45.CrossRef
7.
go back to reference Smith EM, Gowran RJ, Mannan H, et al. Enabling appropriate personnel skill-mix for progressive realization of equitable access to assistive technology. Disabil Rehabil Assist Technol. 2018;13:445–53.CrossRef Smith EM, Gowran RJ, Mannan H, et al. Enabling appropriate personnel skill-mix for progressive realization of equitable access to assistive technology. Disabil Rehabil Assist Technol. 2018;13:445–53.CrossRef
9.
go back to reference World Health Organization. Financing and economic aspects of health workforce scale-up and improvement: framework paper: GHWA financing task force, October 2008. Report no. 924159828X, Geneva: World Health Organization; 2009. World Health Organization. Financing and economic aspects of health workforce scale-up and improvement: framework paper: GHWA financing task force, October 2008. Report no. 924159828X, Geneva: World Health Organization; 2009.
10.
go back to reference Chen L, Evans T, Anand S, et al. Human resources for health: overcoming the crisis. Lancet. 2004;364:1984–90.CrossRef Chen L, Evans T, Anand S, et al. Human resources for health: overcoming the crisis. Lancet. 2004;364:1984–90.CrossRef
12.
go back to reference ATscale. Product narrative: prostheses. A market landscape and strategic approach to increasing access to prosthetic devices and related services in low- and middle-income countries. Geneva: AT2030 Programme; 2020. ATscale. Product narrative: prostheses. A market landscape and strategic approach to increasing access to prosthetic devices and related services in low- and middle-income countries. Geneva: AT2030 Programme; 2020.
13.
go back to reference World Health Organization. Transforming and scaling up health professionals’ education and training. World Health Organization Guidelines 2013. Geneva: World Health Organization; 2013. World Health Organization. Transforming and scaling up health professionals’ education and training. World Health Organization Guidelines 2013. Geneva: World Health Organization; 2013.
14.
go back to reference Clarke D. Law, regulation and strategizing for health. Strategizing national health in the 21st century: a handbook. Geneva: World Health Organization; 2016. Clarke D. Law, regulation and strategizing for health. Strategizing national health in the 21st century: a handbook. Geneva: World Health Organization; 2016.
15.
go back to reference World Health Organization. Strengthening health workforce regulation in the Western Pacific Region. Report no. 9290617705, 2016. Manila: WHO Regional Office for the Western Pacific. World Health Organization. Strengthening health workforce regulation in the Western Pacific Region. Report no. 9290617705, 2016. Manila: WHO Regional Office for the Western Pacific.
16.
go back to reference Summers M, Walker L. National credentialing and accreditation for assistive technology practitioners and suppliers: an options paper. Canberra: Assistive Technology Suppliers Australasia; 2013. Summers M, Walker L. National credentialing and accreditation for assistive technology practitioners and suppliers: an options paper. Canberra: Assistive Technology Suppliers Australasia; 2013.
17.
go back to reference Benton D, González-Jurado M, Beneit-Montesinos J. A structured policy review of the principles of professional self-regulation. Int Nurs Rev. 2013;60:13–22.CrossRef Benton D, González-Jurado M, Beneit-Montesinos J. A structured policy review of the principles of professional self-regulation. Int Nurs Rev. 2013;60:13–22.CrossRef
18.
go back to reference National Alliance of Self-Regulating Health Professions. Harnessing self-regulation to support safety and quality in healthcare delivery: A comprehensive model for regulating all health practitioners. Melbourne: Allied Health Professions Australia; 2012. National Alliance of Self-Regulating Health Professions. Harnessing self-regulation to support safety and quality in healthcare delivery: A comprehensive model for regulating all health practitioners. Melbourne: Allied Health Professions Australia; 2012.
20.
go back to reference World Health Organization. Global strategy on human resources for health: workforce 2030. Report no. 9241511133, Geneva: World Health Organization; 2016. World Health Organization. Global strategy on human resources for health: workforce 2030. Report no. 9241511133, Geneva: World Health Organization; 2016.
21.
go back to reference World Health Organization. Global Perspective on assistive technology: proceedings of the GReAT Consultation 2019. In: Layton N, Borg J, editors. GReAT Consultation 22–23 August 2019. Geneva: World Health Organisation; 2019. p. 169–90. World Health Organization. Global Perspective on assistive technology: proceedings of the GReAT Consultation 2019. In: Layton N, Borg J, editors. GReAT Consultation 22–23 August 2019. Geneva: World Health Organisation; 2019. p. 169–90.
24.
go back to reference Office of the Queensland Parliamentary Counsel. Health Practitioner National Law Act 2009. Australia: Queensland Government; 2009. Office of the Queensland Parliamentary Counsel. Health Practitioner National Law Act 2009. Australia: Queensland Government; 2009.
28.
go back to reference World Health Organization. Preventing chronic diseases: a vital investment. Report no. 9241563001, Geneva: World Health Organization; 2005. World Health Organization. Preventing chronic diseases: a vital investment. Report no. 9241563001, Geneva: World Health Organization; 2005.
29.
go back to reference Banks LM, Kuper H, Polack S. Poverty and disability in low-and middle-income countries: a systematic review. PLoS ONE. 2017;12:e0189996.CrossRef Banks LM, Kuper H, Polack S. Poverty and disability in low-and middle-income countries: a systematic review. PLoS ONE. 2017;12:e0189996.CrossRef
34.
go back to reference World Health Organization. WHO standards for prosthetics and orthotics (Part 2). Report no. 9241512482, Geneva: World Health Organization; 2017. World Health Organization. WHO standards for prosthetics and orthotics (Part 2). Report no. 9241512482, Geneva: World Health Organization; 2017.
35.
go back to reference Ash S, O’Connor J, Anderson S, et al. A mixed-methods research approach to the review of competency standards for orthotist/prosthetists in Australia. Int J Evid Based Healthc. 2015;13:93–103.CrossRef Ash S, O’Connor J, Anderson S, et al. A mixed-methods research approach to the review of competency standards for orthotist/prosthetists in Australia. Int J Evid Based Healthc. 2015;13:93–103.CrossRef
36.
go back to reference The Australian Orthotic and Prosthetic Association Inc. Entry level competency standards of australian orthotists/prosthetists (3rd Edition). Australia: The Australian Orthotic and Prosthetic Association Inc; 2014. The Australian Orthotic and Prosthetic Association Inc. Entry level competency standards of australian orthotists/prosthetists (3rd Edition). Australia: The Australian Orthotic and Prosthetic Association Inc; 2014.
37.
go back to reference The Australian Orthotic Prosthetic Association. Course accreditation standards for orthotic/prosthetic tertiary education programs in Australia. Australia: The Australian Orthotic Prosthetic Association; 2016. The Australian Orthotic Prosthetic Association. Course accreditation standards for orthotic/prosthetic tertiary education programs in Australia. Australia: The Australian Orthotic Prosthetic Association; 2016.
38.
go back to reference National Alliance of Self Regulating Health Professions. Self regulating health profession peak bodies membership standards. Melbourne: NASRHP; 2016. National Alliance of Self Regulating Health Professions. Self regulating health profession peak bodies membership standards. Melbourne: NASRHP; 2016.
39.
go back to reference Australian Government Department of Veterans’ Affairs. Notes for allied health providers, section one: general. Australia: Australian Government Department of Veterans’ Affairs; 2020. Australian Government Department of Veterans’ Affairs. Notes for allied health providers, section one: general. Australia: Australian Government Department of Veterans’ Affairs; 2020.
40.
go back to reference Australian Government Federal Register of Legislation. Migration (LIN 19/051: Specification of Occupations and Assessing Authorities) Instrument 2019. Canberra: Australian Government; 2019. Australian Government Federal Register of Legislation. Migration (LIN 19/051: Specification of Occupations and Assessing Authorities) Instrument 2019. Canberra: Australian Government; 2019.
41.
go back to reference World Health Organization. World Report on Disability 2011. Report no. 9241564180, Geneva: World Health Organization; 2011. World Health Organization. World Report on Disability 2011. Report no. 9241564180, Geneva: World Health Organization; 2011.
42.
go back to reference International Society for Prosthetics and Orthotics. ISPO Education Standards for Prosthetic/Orthotic Occupations. Brussels: International Society for Prosthetics and Orthotics; 2018. International Society for Prosthetics and Orthotics. ISPO Education Standards for Prosthetic/Orthotic Occupations. Brussels: International Society for Prosthetics and Orthotics; 2018.
44.
go back to reference Coltman L, Roberts B. City to city twinning relationships: Are there measurable benefits? UWill Discover Undergraduate Conference. Ontario: University of Windsor; 2018. Coltman L, Roberts B. City to city twinning relationships: Are there measurable benefits? UWill Discover Undergraduate Conference. Ontario: University of Windsor; 2018.
46.
go back to reference Ndenga E, Uwizeye G, Thomson DR, et al. Assessing the twinning model in the Rwandan Human Resources for Health Program: goal setting, satisfaction and perceived skill transfer. Glob Health. 2016;12:4.CrossRef Ndenga E, Uwizeye G, Thomson DR, et al. Assessing the twinning model in the Rwandan Human Resources for Health Program: goal setting, satisfaction and perceived skill transfer. Glob Health. 2016;12:4.CrossRef
47.
go back to reference Borg J, Lindström A, Larsson S. Assistive technology in developing countries: a review from the perspective of the Convention on the Rights of Persons with Disabilities. Prosthet Orthot Int. 2011;35:20–9.CrossRef Borg J, Lindström A, Larsson S. Assistive technology in developing countries: a review from the perspective of the Convention on the Rights of Persons with Disabilities. Prosthet Orthot Int. 2011;35:20–9.CrossRef
Metadata
Title
Regulation of the global orthotist/prosthetist workforce, and what we might learn from allied health professions with international-level regulatory support: a narrative review
Authors
Leigh Clarke
Louise Puli
Emily Ridgewell
Michael P. Dillon
Sarah Anderson
Publication date
01-12-2021
Publisher
BioMed Central
Published in
Human Resources for Health / Issue 1/2021
Electronic ISSN: 1478-4491
DOI
https://doi.org/10.1186/s12960-021-00625-9

Other articles of this Issue 1/2021

Human Resources for Health 1/2021 Go to the issue