Capacity Building Using Digital Technology for Occupational Therapists and Caregivers in Pakistan: A Participatory Action Research Approach


  • Rukaiya Yawar Institute of Business Administration, Karachi, Pakistan
  • Zaheeruddin Asif Institute of Business Administration, Karachi, Pakistan



caregiver, developmental disabilities, occupational therapy, telehealth, therapeutic communication


This paper describes the development and implementation of a telehealth system in Pakistan to build capacity of healthcare service providers and caregivers of children with developmental disabilities. An asynchronous telehealth system, in the form of a web app, improved therapy-related communication between the therapists and caregivers, thus enabling capacity building through sustained communication among the stakeholders. Participatory Action Research (PAR) identified barriers associated with communication, knowledge transfer, and caregiver learning. Data were collected via observations, interviews, focus groups, and field notes. The experiences of therapists and caregivers were analyzed to design and develop a system that works as a learning mechanism for caregivers in their native languages. The system also addresses socio-economic, geographic, and communication barriers as well as pandemic-imposed obstacles.



Bhat, A., Su, W.-C., Cleffi, C., & Srinivasan, S. (2021). A hybrid clinical trial delivery model in the COVID-19 era. Physical Therapy, 101(8), pzab116.

Bjerkan, J., Hedlund, M., & Hellesø, R. (2014). Patients’ contribution to the development of a web-based plan for integrated care-A participatory design study. Informatics for Health & Social Care, 40, 167-184.

Borhani-Haghighi, A., Bavarsad Shahripour, R., & Azarpazhooh, M. R. (2020). Time is brain: A call to action to support stroke centers in low- and middle-income countries during the COVID-19 pandemic. European Neurology, 83(3), 310–311.

Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101.

Camden, C., & Silva, M. (2021). Pediatric telehealth: Opportunities created by the COVID-19 and suggestions to sustain its use to support families of children with disabilities. Physical & Occupational Therapy in Pediatrics, 41(1), 1–17.

Cason, J. (2011). Telerehabilitation: An adjunct service delivery model for early intervention services. International Journal of Telerehabilitation, 3(1), 19–30.

Hamdani, S., Atif, N., Tariq, M., Minhas, F., Iqbal, Z., & Rahman, A. (2014). Family networks to improve outcomes in children with intellectual and developmental disorders: A qualitative study. International Journal of Mental Health Systems, 8(1), 7.

Harris, B., Ajisola, M., Alam, R., Watkins, J. A., Arvanitis, T. N., Bakibinga, P., Chipwaza, B., Choudhury, N., Fayhun, O., Kibe, P., Omigbodun, A., Owoaje, E., Pemba, S., Potter, R., Rizvi, N., Sturt, J., Cave, J., Iqbal, R., Kabaria, C., … Griffiths, F. (2021). Mobile consulting as an option for accessing healthcare services for communities in remote rural areas and urban slums in low- and middle- income countries: A mixed methods study. Digital Health, 7.

Khan, U. Z. (2020). Telemedicine in the COVID-19 era: A chance to make a better tomorrow. Pakistan Journal of Medical Sciences, 36(6), 1405–1407.

Kislov, R., Waterman, H., Harvey, G., & Boaden, R. (2014). Rethinking capacity building for knowledge mobilisation: Developing multilevel capabilities in healthcare organisations. Implementation Science, 9(1), 166.

Langkamp, D. L., McManus, M. D., & Blakemore, S. D. (2014). Telemedicine for children with developmental disabilities: A more effective clinical process than office-based care. Telemedicine Journal and E-Health, 21(2), 110–114.

Lim, S. Y., Jarvenpaa, S. L., & Lanham, H. J. (2015). Barriers to interorganizational knowledge transfer in post-hospital care transitions: Review and directions for information systems research. Journal of Management Information Systems, 32(3),48-74.

Masood, A. (2019). Influence of marriage on women’s participation in medicine: The case of doctor brides of Pakistan. Sex Roles, 80(1), 105–122.

Miller, B. J. (2020). Telemedicine after COVID: An unanticipated benefit to a pandemic. Journal of Pakistan Orthopaedic Association, 32(02), 53–55.

Mishra, K., & Siddharth, V. (2018). Utilization of institutional rehabilitation service in pediatric patients with disability in Southwest Rajasthan. Journal of Family Medicine and Primary Care, 7(4), 703–708.

Nadeem, T., Siddiqui, S., & Asad, N. (2020). Initiating psychiatry teleclinics during the COVID-19 pandemic in a tertiary care hospital in Karachi, Pakistan. Psychological Trauma: Theory, Research, Practice, and Policy, 12(7), 807.

Olusanya, B. O., Davis, A. C., Wertlieb, D., Boo, N.-Y., Nair, M. K. C., Halpern, R., Kuper, H., Breinbauer, C., De Vries, P. J., & Gladstone, M. (2018). Developmental disabilities among children younger than 5 years in 195 countries and territories, 1990–2016: A systematic analysis for the Global Burden of Disease Study 2016. Lancet Global Health, 6(10), e1100–e1121.

Reichow, B., Kogan, C., Barbui, C., Smith, I., Yasamy, M. T., & Servili, C. (2014). Parent skills training for parents of children or adults with developmental disorders: Systematic review and meta-analysis protocol. BMJ Open, 4(8), e005799.

Salomone, E., Pacione, L., Shire, S., Brown, F. L., Reichow, B., & Servili, C. (2019). Development of the WHO Caregiver Skills Training Program for Developmental Disorders or Delays. Frontiers in Psychiatry, 10.

Zahid, Z., Atique, S., Saghir, M. H., Ali, I., Shahid, A., & Malik, R. A. (2017). A Commentary on telerehabilitation services in Pakistan: Current trends and future possibilities. International Journal of Telerehabilitation, 9(1), 71–76.




How to Cite

Yawar, R., & Asif, Z. (2022). Capacity Building Using Digital Technology for Occupational Therapists and Caregivers in Pakistan: A Participatory Action Research Approach. International Journal of Telerehabilitation, 14(2).



Country Reports