Profile of occupational therapy services in non-urban settings: A global scoping review.
Karen Hayes, Vagner Dos Santos, Moses Costigan and 1 others
PMID 35949174WHAT IT FOUND
Most non-urban occupational therapy services are delivered by urban-based therapists via outreach or telehealth, focusing on individual rehabilitation for specific diagnoses.
Community-level interventions are rare, particularly in wealthy nations, despite the high burden of disease in these regions.
Key findings
01Urban outreach services, where providers travel or use telehealth, were the most commonly described model (45%), followed by local community services (30%).
02Global North publications focused heavily on individual remediation strategies (71% of strategies), while Global South publications more commonly addressed community-level needs and generalist care.
03Only 14% of publications described community-level enablement strategies, with redistributive justice interventions appearing in just 3% of studies.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The review only included publications in English, Spanish, French, and Portuguese, potentially excluding relevant work from other regions. Fewer than 20% of countries with occupational therapy presence had published on this topic, indicating a severe lack of global data. Definitions of 'non-urban' were inconsistent across studies, relying on the authors' own descriptions rather than standardized criteria. The search did not include the SciELO database, which may have missed Global South publications. Most included studies were qualitative or descriptive, limiting the ability to assess clinical effectiveness.
Declared interests
The authors declare no conflict of interest.
The easy way to misread this
Do not interpret the high volume of Global North publications as evidence that these services are more effective or better established. The review highlights a research and practice bias, where urban-centric models dominate the literature, while potentially valuable community-level approaches from the Global South are underrepresented.