Developing a Global Strategy for strengthening the occupational therapy workforce: A two-phased mixed methods consultation of country representatives shows the need for clarifying task-sharing strategies

Abstract Introduction Occupational therapy has been underdeveloped and often neglected in the global health workforce agenda, contrasting with the global raise of population needs for services. The World Federation of Occupational Therapists (WFOT) is utilising a research-based process for developing and refining a global strategy for strengthening the occupational therapist workforce to meet population needs for occupational therapy. A multi-pronged scoping review, situational analysis, expert input process, and examination of global health workforce developments enabled the drafting of a provisional strategy that was subsequently subject to feedback from representatives of WFOT member organisations. Methods Two-phased, mixed-methods consultation consisting of: 1) mixed-methods online survey with score ratings and comments on the utility of each strategy; and 2) in-person focus groups discussions (n = 4) on low-scoring items involving a total of 76 representatives of WFOT member organisations. The focus group discussions were analyzed using an inductive thematic analysis approach. Results Strategies involving ‘task shifting / task sharing’ or the ‘harmonization of workforce data-collection requirements’ received the lowest scores in the initial survey and were thereby addressed in the focus groups discussions. The overarching theme of the focus groups was the need to: “clarify, specify, and contextualize the strategies”, including: 1) “clarify the terminology and specify the application”, for example, describe the meaning of task shifting, specify which tasks can (and cannot) be shifted and to whom, to address concerns regarding scope-of-practice, service demand, and safety; and 2) “outline the context of need and the context for the implementation” of the strategies, elucidating why the strategies are needed and how they can be feasibly implemented across the different jurisdictional contexts. Conclusion Within a mixed-methods consultation, WFOT representatives identified challenging topics on the draft workforce strategies and suggested methods to improve the global strategy, its acceptability, and implementation. The terms ‘task shifting / task sharing’ raised the greatest discussion among the profession leaders, when the strategy is not sufficiently clarified, specified, or contextualized.