Workforce data can help determine the current and future supply of the occupational therapy workforce and promote supply comparisons. However, improving access to workforce data is not enough. To further determine supply gaps of the occupational therapy workforce, it is necessary to align the data with population needs and health system demands for occupational therapy. For example, combining workforce data with labour-market analyses, where available, can identify vital gaps in access and provision of occupational therapy services.

Problem and opportunity

The supply of occupational therapists is largely imbalanced relative to population needs and health system demands. The imbalance exists across income levels of countries and after adjusting for population needs, size, and socio-economic, geographic and demographic variables.

Identified weaknesses ^{9, 16, 18}

Few studies of workforce supply gaps are conducted for occupational therapists as a single profession or as part of the broader rehabilitation workforce. Those studies that are conducted are not updated, are geographically bounded, do not follow advanced and participatory situation analyses, or do not often result in substantive workforce policy and practice changes.
In many LMICs, occupational therapy and other rehabilitation systems of care are severely underdeveloped, particularly when population ageing and the growing need for rehabilitation are considered. Occupational therapists are far from able to meet the current and future population needs for occupational therapy service provision.
When a massive undersupply exists, it is difficult to meet the greater population demand for occupational therapy services. Most of the population is unaware of occupational therapists or the benefits attained from their services. Health providers also may lack such awareness, and thereby are not likely to increase referrals for occupational therapy; even if they do, the undersupply is not capable of managing an increased demand. These phenomena perpetuate the cycle of undersupply, which is further aggravated by limited occupational therapy education capacity to increase supply.
Within high-income nations, striking variations exist in the supply of occupational therapists relative to other rehabilitation therapists, ranging, for example, from a nearly equal representation of occupational and physical therapists in Israel to a 49-to-1 ratio in favour of physical therapists in Italy.²⁴

Opportunities for advancement of occupational therapy

Within the Rehabilitation 2030 initiative,²⁶ the World Health Organization is leading international initiatives to develop tools, knowledge, advocacy, and the overall momentum for expanding the rehabilitation workforce, particularly in LMICs.
Health labour-market analyses^27-29 and guidelines^{29 30} are increasingly available for determining market forces and gaps in health labour markets, although not used for occupational therapy. No formal labour-market analyses of the occupational therapy workforce were found in a scoping review to inform workforce policy, planning or management.^{9 17}

Objectives

Long-Term Goals (three cycles of four years)

Identifed gaps or disparities in the supply of occupational therapists, including in the severely undersupplied lower- and middle-income countries lead to or inform the development of supply strengthening initiaitives.

Short-Terms Goals (one cycle of four years)

Determination of current or future population-based requirements for occupational therapists, based on population- or health system needs, or market demand.
Systematic analyses of need- or demand-based shortages, surplus, or geographic imbalances in the supply of occupational therapists.
Performance of labour-market or situational analyses assessing the status of the occupational therapy workforce to inform workforce policy, planning or management.

Specific actions and tasks

The specific actions address developing need- or demand-based determinations of occupational therapy supply gaps, as appropriate for the health system context. For example, pure demand-based analyses might be inappropriate for severely underdeveloped rehabilitation systems of care, public-based health delivery systems, or for comparing rural versus urban contexts within a nation. In these contexts, needs-based analyses may help detect market failures and inform population-centred, equity-oriented health workforce policies and planning. Finally, local or regional labour-market analysis can uncover unique local labour-market dynamics informing policy, planning, and organizational or service-level workforce management.

Determine current and future population needs for occupational therapists and any shortages, surplus, or geographic disparities within and across nations.

a. Use existing health, functional, disability, and other epidemiological datasets to determine the population need for occupational therapy services.

b. Determine health system requirements for an occupational therapy workforce, by combining system requirements (e.g., hours required to serve a population) with population needs (e.g., the size of the populations ‘needing’ the services).

c. Determine shortages, surplus, and inequitable distributions of the occupational therapy workforce by comparing occupational therapy workforce requirements with the current or forecasted supply of occupational therapists.

d. Develop scenario-based workforce-need projections that consider factors such as changes in the political, economic, socio-demographic, epidemiological and other circumstances affecting population need or demand for occupational therapists.

Examine the demand for occupational therapists to determine supply gaps and labour-market imbalances.

a. Obtain, collate, and analyse data regarding occupational therapy demand (e.g., occupational therapy service utilization; unfilled vacancy rates) to identify the current and future demand for occupational therapy workers over time and in response to different circumstances.

b. Develop demand-based forecasting models based on demand- and supply-based data, under varying assumptions and socio-economic and political scenarios.

c. Conduct local labour-market analyses to inform management of the workforce at the regional, organizational, and service-unit level (e.g., using the WHO Health Labour Market Analysis Guidebook).

Conduct comprehensive analyses of occupational therapy human resources as a single profession and as part of a broader health workforce.

a. Conduct situational analyses of the occupational therapy workforce, within the profession as part of broader rehabilitation and workforce situation assessments.

b. Engage occupational therapy stakeholders in selecting, using, and interpreting workforce data in situational analyses of the occupational therapy or broader health workforce.

c. Translate situational assessments into multi-year, strategic and action plans for strengthening of occupational therapy workforce, with continuous monitoring and update.