Masters Degrees (Centre for Disability and Rehabilitation Studies)

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Browsing Masters Degrees (Centre for Disability and Rehabilitation Studies) by Author "Gysman, Nozipiwo Joyce"

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    An exploration and description of rural rehabilitation service model in the Mbhashe Municipality, Amathole district in the Eastern Cape Province of South Africa : a pilot study
    (Stellenbosch : Stellenbosch University, 2020-03) Gysman, Nozipiwo Joyce; Mji, Gubela; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Rehabilitation Studies.
    ENGLISH SUMMARY : Background: People with disabilities are still disadvantaged in accessing health and rehabilitation services, especially those who reside in rural areas, despite the available policies. Rehabilitation is one of the components of Primary Health Care (PHC) but it remains excluded and poorly understood in PHC programmes. Despite available policies to address rehabilitation for people with disabilities (PWDs), PWDs still have difficulty accessing the rehabilitation services. Rehabilitation remains: •excluded and poorly understood in PHC programmes, •fragmented and uncoordinated with services inaccessible to some parts ofsociety especially in the rural context compared to urban counterparts, •dominated by the medical model and institutionalization of services, and •questionable in terms of relevance of services as there is less involvement,guidance and support from communities where these rehabilitation servicesare being provided. Aim of the study: To explore and describe rehabilitation services rendered in a rural setting of Mbashe municipality in the Eastern Cape Province in South Africa. Study objectives: To describe the rehabilitation and health services in the selected area; to identify the key role players for rehabilitation services in this area (both community-based and institution-based); to describe the rehabilitation pathways available within the health facilities and the community; to explore the challenges experienced by all role players delivering rehabilitation services in the study area; to determine the perceptions of people with disabilities with regards to the current model of rehabilitation in the study area; and, to make recommendations for addressing the challenges with regard to rehabilitation services in the study area and the existing rehabilitation model. Method: A qualitative exploratory and descriptive study design was implemented to describe the rural rehabilitation service model in the Mbashe Municipality in the Amathole District in the Eastern Cape Province of South Africa. Four areas out of nine (Gusi, Hobeni, Nkanya and Xhora) were conveniently selected in the study setting. In-depth interviews were conducted with Health Professionals from the District hospital (Madwaleni). Semi-structured interviews were conducted with the community representatives inclusive of, the Clinic Nurse Practitioner (one from each of the clinics in four selected areas); The Chief/Chieftain (one from each area in four selected areas); and a person with a disability, a representative of persons with disabilities. Focus group discussions (a group from each area) were conducted with persons with disabilities their families and their communities. Instruments used for developing interviewing schedules for data collection were based on Kaplan’s Framework of Organisational Capacity, (1999) and the Wheel of Opportunities (Lorenzo & Sait, 2000). These instruments were used interchangeable to address the objectives of the study. Qualitative methods of data analyses were applied whereby segments of data were broken down into manageable categories which were later grouped and subjected to content analysis to identify emerging themes. Findings: Themes that emerged from interviews conducted with health professionals, communities and focus group discussions with persons with disabilities revealed that the current model of rehabilitation was institution-based. Participants in rehabilitation services, though aware of available health and rehabilitation services, experienced their main challenge in gaining access to these services. One of the main challenges was related to transport to gain access to health and rehabilitation services. Home visits were not part of the rehabilitation services and this limited rehabilitation professionals in understanding about home and cultural situations of their patients. Rehabilitation goals were not fully met with one of the highest goals of rehabilitation – which is community participation – was not met by persons with disabilities in their rehabilitation process. Conclusion: The study findings indicated a need for the development of a rehabilitation model that will be accessible and will provide an opportunity for participation as well as integration of persons with disabilities with their families as well as their communities. Community-based rehabilitation was seen as a suitable rehabilitation service model for this rural community.