Guidelines for interprofessional practice in rehabilitation at primary health care level

Abstract

Background: Interprofessional practice (IPP) is essential for strengthening rehabilitation services within primary health care (PHC) settings. However, many healthcare professionals currently in the workforce have not been trained in interprofessional education (IPE), which limits effective collaboration.
Aim: This study aimed to develop and validate interprofessional activity guidelines that align with core interprofessional competencies and support the implementation of a rehabilitation model at the PHC level in South Africa.
Setting: The study was conducted remotely with geographically diverse experts but remained grounded in the South African PHC context. It focused specifically on the Western Cape Department of Health.
Methods: A two-round Delphi technique was used to gather expert consensus. In Round One, 15 experts identified 26 interprofessional activity guidelines aligned with the 5 phases of an existing PHC rehabilitation model. In Round Two, 11 experts evaluated the guidelines for consensus and convergence. A consensus threshold of 70% agreement and a convergence threshold of a median score above 3.24 were used.
Results: Of the 26 guidelines, 25 achieved the required 70% consensus. One guideline, which did not reach the consensus percentage, was retained based on a median score above 3.24, indicating convergence of expert opinion. All guidelines were mapped to the four IPE core competencies.
Conclusion: This study presents validated interprofessional activity guidelines to enhance rehabilitation services at the PHC level. Aligned with core competencies, these guidelines support practical implementation through a phased approach, with readiness assessments and ongoing evaluation recommended. The Delphi-informed process may be adapted for similar resource-limited health systems.
Contribution: The results from this study provides validated activity guidelines that translate a South African health policy vision into actionable steps for IPP in the rehabilitation sector at the PHC level. The guidelines strengthen teamwork, communication and patient-centred care across disciplines, offering a replicable model for improving coordination and service delivery in African PHC contexts.