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Introduction/Background: Despite the prevalence of disability in low-and-middle income countries (LMICs), the clinical skills of rehabilitation workforce are not well described. We report health professionals’ perspectives on clinical skills in austere settings and identify context-specific gaps for workforce capacity. Material and method: An exploratory-descriptive, cross-sectional, pilot survey of healthcare professionals working in rehabilitation in hospital and community settings conducted in Pakistan, Morocco, Nigeria and Malaysia. A situational-analysis survey-tool captured cross-sectional assessment of clinical skills required in various rehabilitation settings. Participant responses were coded in a line-by-line process, and clustered into common terms based on International Classification of Functioning, Disability and Health (ICF) framework to classify skill-categories in target domains. Results: Survey respondents (n = 532) from Pakistan 248, Nigeria 159, Morocco 93 and Malaysia 32 completed the survey. The participants were: physiotherapists (52.8%), nurses (8.8%), speech and occupational therapists (8.5%, 5.3%), other medical doctors (5.5%), rehabilitation physicians (3.8%), and prosthetist/orthotists (1.5%). The 10 most commonly used clinical skills reported were prescription of physical activity and medications, transfer-techniques, daily-living activities, allied health interventions, patient/carer education, comprehensive patient-care, diagnosis/screening, behaviour/cognitive interventions, referrals, assessments and collaboration. Most responses linked with ICF categories in activities/participation, and personal factors. Conclusion: The survey tool identified task shifting amongst healthcare professionals. The core skills and gaps reflected general rehabilitation practice, rather than discipline-specific skills.

Objective: Despite the prevalence of disability in low-and middle-income countries, the clinical skills of the rehabilitation workforce are not well described. We report health professionals’ perspectives on clinical skills in austere settings and identify context- specific gaps in workforce capacity. Methods: A cross-sectional pilot survey (Pakistan, Morocco, Nigeria, Malaysia) of health professionals working in rehabilitation in hospital and community settings. A situational-analysis survey captured assessment of clinical skills required in various rehabilitation settings. Responses were coded in a line-byline process, and linked to categories in domains of the International Classification of Functioning, Disability and Health (ICF). Results: Respondents (n = 532) from Pakistan 248, Nigeria 159, Morocco 93 and Malaysia 32 included the following: physiotherapists (52.8%), nurses (8.8%), speech (5.3%) and occupational therapists (8.5%), rehabilitation physicians (3.8%), other doctors (5.5%) and prosthetist/orthotists (1.5%). The 10 commonly used clinical skills reported were prescription of: physical activity, medications, transfer- techniques, daily-living activities, patient/carer education, diagnosis/screening, behaviour/cognitive interventions, comprehensive patient-care, referrals, assessments and collaboration. There was significant overlap in skills listed irrespective of profession. Most responses linked with ICF categories in activities/participation and personal factors. Conclusion: The core skills identified reflect general rehabilitation practice and a task-shifting approach, to address shortages of health workers in low-and middle-income countries. Key words: disability; rehabilitation