Practice models for implementing Rehabilitation in international cooperation

The demand for rehabilitation services is increasing globally, particularly in low- and middle-income countries. Physiotherapists dispatched as Japan Overseas Cooperation Volunteers (JOCV) through the Japan International Cooperation Agency support capacity strengthening in diverse health systems; however, the combinations of elements that enable rehabilitation practice to function effectively in international cooperation, and the conditions under which practice stagnates, remain insufficiently systematized.

To develop practice models describing how professional expertise, contextual adaptation, and collaboration shape effective and stagnated practices among JOCV physiotherapists.

A qualitative content analysis was conducted using activity reports of JOCV physiotherapists whose service periods fell between 2014 and 2024. Report sets with all five reports completed were included. Item 3 of Report 4, which describes successful and unsuccessful practices, was the primary analytical material. Practice-related descriptions were extracted, classified as effective or stagnated (i.e. showing limited progress), and interpreted to construct practice models.

Overall, 123 report sets were included, of which 117 contributed 258 text segments to the qualitative analysis. Effective practices were classified into four categories: design, sharing of processes and outcomes, and embedding of professional interventions; establishment of working relationships and conditions through contextual understanding; development of collaborative practices respecting local autonomy; and reflective repositioning of professional identity. Stagnated practices were also grouped into four categories: stagnation in relationship-building and collaboration; weakened structures for activity design and evaluation; insufficient conditions for sustaining activities at placement sites; and failed implementation of professional expertise and role confusion.

International rehabilitation cooperation by physiotherapists is not merely technical transfer but also a professional practice integrating rehabilitation knowledge with local relationships, organizational structures, and environmental factors.