An analysis of the organizational framework of rehabilitation services at a community health centre in the Western Cape

[摘要] ENGLISH ABSTRACT:BackgroundIn the past, a lack of policy guidelines in the area of rehabilitation often resulted inunderdeveloped or no rehabilitation services in many areas. This led to the development ofThe South African National Rehabilitation Policy (NRP) which was finalised in 2000. Thispolicy is guided by the principles of development, empowerment and the social integration ofpersons with disabilities. It aims to provide improved access to rehabilitation services for alland forms part of a strategy to improve the quality of life of persons with disabilities.South Africa ratified the United Nations Convention for the Rights of Persons with Disabilities(UNCRPD) in 2001. The UNCRPD is an international rights based document and focuses onequalisation of opportunities for people with disabilities and their inclusion in development.AimThe aim of thestudy was to describe and analyse the organizational framework ofrehabilitation services at the Gugulethu Community Health Centre (CHC) in Cape Town andto determine if the framework used complied with the objectives of the NationalRehabilitation Policy.MethodThis was a case study that made use of both qualitative and quantitative methods of datacollection. The Kaplan framework, the objectives of the NRP and the five relevant articles ofthe UNCRPD were used to design three questionnaires for data collection. The firstquestionnaire was for service providers and answered by seven participants. The secondquestionnaire was completed by the Facility Manager of Gugulethu CHC and the thirdquestionnaire was answered by the managers of 2 purposively sampled NGOs in Gugulethu.Qualitative data was collected from interviews held with three of the service providers andthe facility manager as well as from two focus groups held with service users.ResultsThe results of the study showed that there was some coherence between the rehabilitationservices provided and the objectives of the NRP such as good access to the service forclients coming to the Centre for rehabilitation and adequate resources to provide assistive devices with. However, in other areas there was little or no adherence. Limited evidence ofintersectoral collaboration was found. There was no evidence of the inclusion of personswith disabilities in the planning, implementation and managing of rehabilitation services.Similarly services were not monitored and evaluated in a constructive way and while thetherapists did engage in skills development activities the suitability of the courses attendedfor their role is questioned.ConclusionThe findings showed a facility based curative rehabilitation service that was accessible forclients who came to the facility, but did not expand to provide community basedrehabilitation. Thus it was concluded that the organisation in its current form lacked theability to effectively address the needs of the community that it served. At GugulethuCommunity Health Centre rehabilitation services need to be planned according tocommunity based rehabilitation strategies by the manager, the service providers and thecommunity. Only when implementation of the NRP and UNCRPD takes place will thebenefits become tangible to the entire community.Key WordsRehabilitation, Disability, National Rehabilitation Policy, UNCRPD, Organisational capacity.

[发布机构] Stellenbosch University