Social factors influencing the education of physiotherapists around disability in Bangladesh

Background
Professions such as physiotherapy are challenged to respond to changes occurring internationally in approaches to disability. Correctly theorising disability enables appropriate responses to emerge, which address issues important to disabled people and thus enhance service effectiveness.
Purpose
The purpose of the research was to utilise evidence drawn from user perspectives around disability in Bangladesh, to inform the theoretical underpinnings of professional physiotherapy education and the training of related healthcare workers.
Sample
Data from service users were collected using twenty-seven individual semi-structured interviews with disabled people who had accessed therapeutic services within the previous year. Data from provider groups were collected using thirty-six individual interviews and focus group discussions.
Design
A qualitative research design was used.
Process of analysis
All final transcripts were in English and a thematic analysis was undertaken in three stages. User group findings were firstly analysed and then compared systematically with each provider group analysis. Comparisons generated usable knowledge which informed theoretical underpinnings around disability.
Findings
Theoretical underpinnings around disability were informed by an individual model of disability in five out of six courses preparing workers for this field in Bangladesh. One course only was underpinned by a social model of disability. This training was based on a strategic, rights-based, development approach to disability. Interventions from this group showed the greatest congruency with perceived needs of service users. A number of changes in course content were identified which will facilitate greater congruency with service user needs in physiotherapy and related healthcare worker preparation. These include the introduction of a fourfold typology of disability, knowledge of practice epistemology, an understanding of professional socialisation, a greater awareness of collectivist value systems and a strategic response to gender stratification.