A description and analysis of the organisational capacity of the rehabilitation services at TC Newman Community Day Centere

[摘要] ENGLISH ABSTRACT: Rehabilitation services, mainly rendered by therapists employed by the Departmentof Health, forms a critical part of the Primary Health Care (PHC) package of care.Different policies, within the Department of Health (DOH), provide guidance onrehabilitation service delivery. However, implementation of these policies remains achallenge.The current study aimed to describe and analyse the organisational capacity ofrehabilitation services at the study site and to assess how congruent therehabilitation service at the study site was with existing rehabilitation policy.A descriptive methodology was applied making use of both quantitative andqualitative methods in analyzing the organisational capacity of this study site and thealignment of rehabilitation services offered, with the National Rehabilitation Policy(NRP). The study used the Kaplan framework, the objectives of the NRP and specificselected articles of the United Nations Convention on the Rights of Persons withDisabilities (UNCRPD) to develop indicators to be used for the description andanalysis of the organisational capacity of the rehabilitation services at TC NewmanCommunity Day Centre.Questionnaires based on seven objectives from the NRP were developed to collectquantitative data from five service providers, the facility manager of TC NewmanCDC and the managers of two Non- Governmental Organisations (NGO) working inthe drainage site. Face to face, audio recorded, semi- structured interviews wereused to collect qualitative data from the five service providers. A folder audit anddocument review was used to enhance quantitative findings. After analysis of thedata, I still felt the need for additional information and thus developed an open endedquestionnaire for participants to complete.Barriers (e.g. defaulting of clients, a lack of standard documentation, poor monitoringand evaluation) and facilitators (e.g. outreach and support, competent staff andmulti-disciplinary team) were identified in implementing the NRP. Participantshighlighted the importance of accessing rehabilitation services with a focus on theoutreach to peripheral clinics and funded NGO's. Intersectoral collaboration isevident, but mainly with funded NGO's. A lack of standardised documentation,inadequate monitoring and evaluation systems and uniformed documentation were some of the challenges identified by participants. The absence of participation bypersons with disabilities was noted by all participants.With reference to the organisational capacity, the participants had a goodunderstanding of rehabilitation within the PHC context. Participants felt confident indelivering rehabilitation services and were able to identify shortcomings in servicedelivery. It is concluded that rehabilitation services are not delivered exactly inaccordance with the objectives of the NRP. However the organisation demonstratedcapacity to deliver rehabilitation services at PHC level, but there is still a need toenhance service delivery on community based level.The results of this study gave me as a manager and implementer of health policy inthe District Health System the opportunity to gain deeper insight as to howrehabilitation services are currently rendered. Results from the study highlighted howcoherent rehabilitation service delivery is with current policy in health and thecapacity of the organisation to deliver rehabilitation services.This gave me the opportunity to adjust and review current rehabilitation servicedelivery and implement changes, as the study progressed.

[发布机构] Stellenbosch University