scholarly journals Examining the Availability and Accessibility of Rehabilitation Services in a Rural District of South Africa: A Mixed-Methods Study

2021 ◽  
Vol 18 (9) ◽  
pp. 4692
Author(s):  
Qhayiya Magaqa ◽  
Proochista Ariana ◽  
Sarah Polack
Keyword(s):  
South Africa ◽  
Unmet Needs ◽  
Physical Disabilities ◽  
Assistive Devices ◽  
Rural District ◽  
Rehabilitation Service ◽  
Rehabilitation Services ◽  
Service Capacity ◽  
Unequal Distribution ◽  
District Hospitals

Introduction: Rehabilitation services aim to optimise individuals’ functioning and reduce disability. However, people with disabilities, who represent a key population of users of rehabilitation services, continue to have unmet needs for rehabilitation services that include the provision of assistive devices. This paper examines the availability and accessibility of rehabilitation services in a rural district of South Africa in order to explore why unmet needs for rehabilitation services persist. Methods: All nine district hospitals in a rural district of South Africa were included in the study. Rehabilitation services capacity was assessed by examining the available assistive devices, consumables and human resources at the level of the health facility. Data collection was conducted using the Global Co-operative Assistive Technology [GATE] Assistive Products List, AT2030’s ATScale priority list and the South African National Catalogue of Commodities for Primary Health Care Facilities. Descriptive statistics were then used for the analysis. For the qualitative component, semi-structured interviews were conducted with adults with physical disabilities at household level to explore barriers to accessing assistive device inclusive rehabilitation services and the consequences thereof in the same rural district. An interview guide based on the WHO health system building blocks was used. Thematic content analysis guided the analysis of the interview transcripts. Findings: The findings of the research demonstrate that rehabilitation service capacity in the district was constrained as a result of low availability of assistive devices [2–22%] and consumables [2–47%], as well as, possibly, a shortage of rehabilitation providers [n = 30] with an unequal distribution across health facilities [n = 9]. In addition, people with physical disabilities reported poor referral pathways, financial constraints, transport and road consideration and equipment unavailability as barriers to accessing rehabilitation services. Moreover, these barriers to access predisposed individuals to finance-, health- and person-related harm. Conclusion: Rehabilitation service availability is constrained by a lack of service capacity in rural South Africa. In addition, the rehabilitation services in district hospitals are not adequately accessible because of existing barriers to enable key populations to achieve optimised functioning.

scholarly journals Investigating competencies needed by European-trained doctors in rural South African hospitals

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
James R. Barnacle ◽  
Oliver Johnson ◽  
Ian Couper
Keyword(s):  
South Africa ◽  
South African ◽  
Online Survey ◽  
Rural District ◽  
Eastern Cape ◽  
Rural Medicine ◽  
Rural South ◽  
District Hospitals ◽  
Kwazulu Natal ◽  
Postgraduate Diploma

Background: Many European-trained doctors (ETDs) recruited to work in rural district hospitals in South Africa have insufficient generalist competencies for the range of practice required. Africa Health Placements recruits ETDs to work in rural hospitals in Africa. Many of these doctors feel inadequately prepared. The Stellenbosch University Ukwanda Centre for Rural Health is launching a Postgraduate Diploma in Rural Medicine to help prepare doctors for such work.Aim: To determine the competencies gap for ETDs working in rural district hospitals in South Africa to inform the curriculum of the PG Dip (Rural Medicine).Setting: Rural district hospitals in South Africa.Methods: Nine hospitals in the Eastern Cape, KwaZulu-Natal and Mpumalanga were purposefully selected by Africa Health Placements as receiving ETDs. An online survey was developed asking about the most important competencies and weaknesses for ETDs when working rurally. The clinical manager and any ETDs currently working in each hospital were invited to complete the survey.Results: Surveys were completed by 19 ETDs and five clinical managers. The top clinical competencies in relation to 10 specific domains were identified. The results also indicate broader competencies required, specific skills gaps, the strengths that ETDs bring to South Africa and how ETDs prepare themselves for working in this context.Conclusion: This study identifies the important competency gaps among ETDs and provides useful direction for the diploma and other future training initiatives. The diploma faculty must reflect on these findings and ensure the curriculum is aligned with these gaps.

scholarly journals A Cross-sectional Survey of Rehabilitation Service Provision for Children with Brain Injury in Selangor, Malaysia

2018 ◽  
Vol 1 (2) ◽  
pp. 45-58
Author(s):  
Ee Lin Tay ◽  
Chee Piau Wong
Keyword(s):  
Brain Injury ◽  
Rural Areas ◽  
Service Provision ◽  
Urban Areas ◽  
Urban Poor ◽  
Service Providers ◽  
Rehabilitation Service ◽  
Rehabilitation Services ◽  
Unequal Distribution ◽  
Persons With Disabilities

Purpose:  Rehabilitation services in Malaysia are provided by both governmental and non-governmental agencies but there are challenges, such as the lack of integration between agencies, and accessibility barriers to services especially for the population of urban poor and people in the rural areas. With the help of a survey, this project aimed to gain a better understanding of rehabilitation services provided for children with brain injury within the state of Selangor and Federal Territories of Kuala Lumpur and Putrajaya.Method:  A list of 205 organisations that provide rehabilitation services for children with neurological injuries was compiled. The researchers attempted to verify the services by visiting the facilities or via telephone or email communication if visits were not possible.Results: The researchers were able to verify 83% of the organisations identified. There are 40 hospitals and 17 service providers for acute and / or chronic physical rehabilitation services for persons with disabilities of all ages, including children.Conclusion: Findings showed the unequal distribution of rehabilitation service provision by districts. Service providers were concentrated in the urban areas. Setting up new healthcare facilities is one of the solutions but the costs for development, construction, and manpower could be high. An alternative solution is proposed, namely, the use of a home-based virtual rehabilitation programme.

scholarly journals Leadership and the functioning of maternal health services in two rural district hospitals in South Africa

2018 ◽  
Vol 33 (suppl_2) ◽  
pp. ii5-ii15 ◽  
Author(s):  
T Mathole ◽  
M Lembani ◽  
D Jackson ◽  
C Zarowsky ◽  
L Bijlmakers ◽  
...  
Keyword(s):  
South Africa ◽  
Maternal Health ◽  
Health Services ◽  
Maternal Health Services ◽  
Rural District ◽  
District Hospitals

scholarly journals Staffing rural hospitals through Umthombo Youth Development Foundation (UYDF) in South Africa: Challenges and Opportunities

2019 ◽  
Author(s):  
Ganzamungu Zihindula ◽  
Richard Gavin MacGregor ◽  
Andrew John Ross
Keyword(s):  
South Africa ◽  
Youth Development ◽  
Rural Areas ◽  
Descriptive Analysis ◽  
Case Study Research ◽  
Health Science ◽  
Rural District ◽  
Staffing Levels ◽  
District Hospitals ◽  
Challenges And Opportunities

Abstract Despite the governments ‘healthcare for all’ focus since the country’s first democratic election in 1994, many rural district hospitals in South Africa have struggled to find and retain adequate staffing levels in order to be able to deliver on the District hospital package of services. Many of these hospitals have relied on non-profit organisations and other privately owned institutions to assist them in improving their staffing levels and service delivery. Umthombo Youth Development Foundation (UYDF), a NPO’s started in 1999 at one rural hospital in the Province KwaZulu-Natal, provides funding to youth from rural areas to study a health science degrees with the understanding that they will return to serve at their rural-based hospitals. This review describes the role that UYDF has played in assisting rural-based hospitals with recruiting and retaining staff, the relationship between UYDF and hospitals, the ‘UYDF’ model, as well as the challenges and opportunities presented through the partnership between UYDF and rural district hospitals. It aims to inform and contribute to health policy initiatives that can help rural-based hospitals to recruit, attract and retain staff. Using a case study research design, existing data was used to present a detailed descriptive analysis of the UYDF health education and employment model. The results from this research paper suggest that the model provides a solution which can address the problem of hospital staffing, and that if challenges are managed, other rural-based hospitals in the country could benefit from the model.

Waiting time for rehabilitation services for children with physical disabilities

2002 ◽  
Vol 28 (5) ◽  
pp. 351-358 ◽  
Author(s):  
D. Ehrmann Feldman ◽  
F. Champagne ◽  
N. Korner-Bitensky ◽  
G. Meshefedjian
Keyword(s):  
Waiting Time ◽  
Physical Disabilities ◽  
Rehabilitation Services

Optimizing a Halfway House to Meet Mental Health Care Users’ Occupational Needs

2021 ◽  
pp. 000841742110448
Author(s):  
Itumeleng Augustine Tsatsi ◽  
Nicola Ann Plastow
Keyword(s):  
Mental Health ◽  
South Africa ◽  
Health Care ◽  
Mental Health Care ◽  
Thematic Analysis ◽  
Unmet Needs ◽  
Participatory Action ◽  
Halfway House ◽  
Health And Wellbeing ◽  
Halfway Houses

Background. Halfway houses (HwH) may support community reintegration of mental health care users and can be effective in meeting occupational needs of residents. However, they are not optimally used in South Africa. Purpose. This study aimed to improve the functioning of a HwH so that it better meets occupational needs of the resident mental health care users. It draws on Doble & Santha; ( 2008 ) seven occupational needs. Method. A four-phase Participatory Action Research methodology was used. We conducted thematic analysis to describe met and unmet needs within PAR phases. Findings. Occupational needs of accomplishment, renewal, pleasure and companionship were being met. However, coherence, agency and affirmation needs were not being met. An additional occupational need for interdependence, based on the African ethic of Ubuntu, was identified. Implications. HwH functioning affected residents’ experiences of health and wellbeing. Engagement in collective occupations can contribute to meeting the occupational need of interdependence.

scholarly journals A qualitative study of the challenges of providing pre-prosthetic rehabilitation in rural South Africa

2017 ◽  
Vol 42 (2) ◽  
pp. 179-186 ◽  
Author(s):  
Liezel Ennion ◽  
Anton Johannesson
Keyword(s):  
South Africa ◽  
Lower Limb ◽  
Rural Setting ◽  
Limb Amputation ◽  
Prosthetic Rehabilitation ◽  
Rural South ◽  
Physical Strength ◽  
District Hospitals ◽  
Fitting In ◽  
Rural South Africa

Background: There is a known shortage of rehabilitation staff in rural settings and a sharp increase in the number of lower limb amputations being performed. A lack of adequate pre-prosthetic rehabilitation will result in worse physical and psychological outcomes for a person with a lower limb amputation, and they will not be eligible to be fitted with a prosthesis. Objective: To explore therapists’ experiences with providing pre-prosthetic rehabilitation in a rural setting. Study design: A qualitative descriptive approach was used to collect and analyse data. Methods: Data were collected from 17 purposively sampled therapists in five district hospitals in a rural community in South Africa. Data were collected in two rounds of focus groups to explore the challenges of providing pre-prosthetic rehabilitation in rural South Africa. Results: The main themes identified in the study were (1) a lack of government health system support, (2) poor socioeconomic circumstances of patients and (3) cultural factors that influence rehabilitation. These themes all negatively influence the therapists’ ability to follow up patients for pre-prosthetic rehabilitation after discharge from hospital. A lack of adequate pre-prosthetic rehabilitation is a substantial barrier to prosthetic fitting in rural South Africa. Patients who do not receive pre-prosthetic rehabilitation have a poorly shaped residuum or other complications such as knee or hip joint contractures which disqualifies them from being referred to prosthetic services. Conclusion: Therapists involved in this study identified the most important barriers to patients having access to prosthetic services. Clinical relevance Pre-prosthetic rehabilitation provides care of the residuum; maintenance or improvement of physical strength, joint range of motion and referral to a prosthetist. By exploring the challenges known to exist in this service, we can identify potential ways to reduce these barriers and improve the lives of those who use it.

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