Research Article
Issue Date: January/February 2021
Published Online: December 11, 2020
Updated: December 14, 2020
Comprehensive Needs Assessment to Ensure Appropriate Rehabilitation Training for Community-Based Workers and Caregivers in India
Author Affiliations
  • Sutanuka Bhattacharjya, PhD, OTR/L, is Assistant Professor, Department of Occupational Therapy, Georgia State University, Atlanta. At the time of the study, Bhattacharjya was PhD student, Department of Rehabilitation Science, University at Buffalo, State University of New York; sbhattacharjya@gsu.edu
  • James A. Lenker, PhD, OTR/L, FAOTA, is Associate Professor, Department of Rehabilitation Science, University at Buffalo, State University of New York.
  • Rachel Schraeder, MS, OTR/L, is Occupational Therapist, North Shore Children’s Therapies, Peabody, MA. At the time of the study, Schraeder was MSOT Student, Department of Rehabilitation Science, University at Buffalo, State University of New York.
  • Rachel Schraeder, MS, OTR/L, is Occupational Therapist, North Shore Children’s Therapies, Peabody, MA. At the time of the study, Schraeder was MSOT Student, Department of Rehabilitation Science, University at Buffalo, State University of New York.
  • Arijit Ghosh, MSW, is Head, Community Based Rehabilitation, Indian Institute of Cerebral Palsy, Kolkata, West Bengal, India.
  • Rabi Ghosh, MSW, is Deputy Head, Community Based Rehabilitation, Indian Institute of Cerebral Palsy, Kolkata, West Bengal, India.
Article Information
Research Articles
Research Article   |   December 11, 2020
Comprehensive Needs Assessment to Ensure Appropriate Rehabilitation Training for Community-Based Workers and Caregivers in India
American Journal of Occupational Therapy, December 2020, Vol. 75, 7501205130. https://doi.org/10.5014/ajot.2021.040097
American Journal of Occupational Therapy, December 2020, Vol. 75, 7501205130. https://doi.org/10.5014/ajot.2021.040097
Abstract

Importance: Rehabilitation researchers and occupational therapy practitioners frequently conduct projects that involve the provision of services or the dissemination of knowledge in low- and middle-income countries (LMICs); however, the needs assessment process underlying these transcultural projects is often underreported.

Objective: To identify a comprehensive set of feeding-related training needs that reflect the culture, resources, and service delivery practices in the West Bengal region of India and that will be used to develop video-based training modules that are contextually relevant and support decentralized training of community-based rehabilitation workers and caregivers of children with cerebral palsy (CP).

Design: Mixed methods design using focus groups and observations.

Setting: Community setting in rural, suburban, and urban locations in West Bengal, India.

Participants: Caregivers of children with CP and community-based rehabilitation workers with experience working with children with CP.

Outcomes and Measures: Focus groups and in-home mealtime observations.

Results: Several findings suggest training priorities that were not anticipated. Caregivers commonly fed children by means of hand feeding while sitting on the floor. Children were fed a limited variation of food consistencies, often in positions of neck hyperextension. Water was frequently used to stimulate swallowing. Caregivers struggled to help children with oral hygiene practices after meals.

Conclusions and Relevance: A thorough needs assessment yielded insights that can favorably alter the trajectory of transcultural service and research projects. For occupational therapists who provide advice on practice, continuing education, or research in a transcultural project, the findings underscore the value of engaging local stakeholders and using firsthand observation.

What This Article Adds: The rigorous, multistakeholder needs assessment process described herein can serve as a road map for researchers and occupational therapy practitioners conducting transcultural projects in LMICs.