Competency frameworks for primary care rehabilitation professionals: a scoping review of global practices and implications for developing countries.

Abstract

Purpose Integrated rehabilitation eases chronic mobility dependence, yet competency frameworks struggle to be implemented in resource-limited regions. To map global competency frameworks for primary care rehabilitation professionals and identify specific implications for workforce development in developing countries. Materials and methods We followed the Arksey and O'Malley framework and PRISMA-ScR guidelines, mapping data against the World Health Organization Rehabilitation Competency Framework (RCF). A comprehensive search was conducted across five databases (PubMed, Web of Science, Embase, CINAHL, ERIC) and grey literature sources from inception to December 2025. Results Of the 4495 initial records identified, 65 documents were included in the final review. Analysis revealed a significant divergence: competence frameworks formulated for high-income nations predominantly emphasize specialized clinical expertise and rigid standardization, whereas frameworks for developing countries prioritize versatility, transdisciplinary task-shifting, and community resource mobilization. A distinct "Adaptive Generalist" profile emerged for resource-limited settings, necessitating "survival competencies" such as resource improvization ("MacGyvering") and social advocacy alongside core clinical skills. Conclusion Transplanting western competency models is insufficient for developing nations. Instead, hybrid frameworks integrating evidence-based clinical standards with adaptive, community-focused competencies are necessary. To prepare skilled practitioners for diverse resource-limited settings, future curricula must officially recognize nontraditional skills such as improvization and task shifting.