Browsing by Author "Conradie, Thandi"

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    Describing the rehabilitation workforce capacity data in the public sector of three rural provinces in South Africa
    (Stellenbosch : Stellenbosch University, 2022-04) Conradie, Thandi; Louw, Quinette; Berner, Karina; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Health and Rehabilitation Sciences. Physiotherapy.
    ENGLISH SUMMARY: Background: Rehabilitation capacity resources are limited or sometimes may be missing completely in low- and middle-income countries. Workforce is intricately linked with all the other health system components and is essential in leadership and governance, management of financial resources and technology, and rehabilitation service delivery. A workforce that is sufficient in number, skills and equitably distributed is vital. The classification of the rehabilitation workforce lacks a common, global definition. A standardised set of descriptors and indicators to describe rehabilitation workforce capacity allows comparison between countries or regions. This rehabilitation workforce data is important to provide a baseline for advocating to improve rehabilitation workforce capacity. Aim: The aim of the study is twofold. Firstly, the aim of the scoping review was to see how rehabilitation workforce capacity data is described and to synthesise the descriptors and indicators used to describe the workforce. Secondly, the aim of the primary study was to describe the rehabilitation workforce in the public sector of South Africa in three rural provinces with respect to number of therapists, distribution by population, type of therapists and qualifications, distribution between rural and urban, salary levels and level of care. Method: The research consisted of a scoping review and a primary study. The scoping review was conducted according to the five-step framework developed by Arksey and O’Malley. The scoping review included primary peer reviewed studies on rehabilitation workforce. Data on the rehabilitation workforce indicators and descriptors were extracted and synthesised. The results were used to describe the primary study workforce data. The primary study was a cross-sectional web-based survey using REDCap. The data was extracted and collated in MS Excel and analysed in SPSS and STATA. Results The findings from the scoping review showed that population adjusted ratios and absolute number of therapists are used to indicate the supply of the rehabilitation workforce. The distribution between urban versus rural and public versus private sectors are used to describe disparities between regions. Age and gender are used to describe the demographics of the rehabilitation workforce. The primary study results indicated that the population adjusted ratios for the rehabilitation workforce are alarmingly low. The number of therapists at primary level are minimal in comparison with secondary hospitals. There is a large disparity between the number of therapists working in rural areas versus the large number who work in urban areas. A third of the rehabilitation workforce rely on community service posts to staff their facilities. Conclusion: Collectively these findings imply that many people depending on the public sector arguably do not have access to rehabilitation services. South Africa will have to invest in strategies to monitor workforce capacity overtime to ensure further declines in the public health sector.
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    Rehabilitation and primary care treatment guidelines, South Africa
    (World Health Organization, 2022-08-22) Conradie, Thandi; Charumbira, Maria; Bezuidenhout, Maryke; Leong, Trudy; Louw, Quinette
    The World Health Organization recognizes rehabilitation as an essential component of universal health coverage (UHC). In many countries, UHC builds on a standard benefits package of services that is informed by the country’s essential medicines list, standard treatment guidelines and primary health care essential laboratory list. In South Africa, primary health care is largely provided and managed by primary health-care nurses and medical officers in accordance with primary health care standard treatment guidelines. However, rehabilitation is mostly excluded from these guidelines. This paper describes the 10-year process that led to rehabilitation referral recommendations being considered for inclusion in South Africa’s primary health care standard treatment guidelines. There were five key events: (i) a breakthrough moment; (ii) producing a scientific evidence synthesis and formulating recommendations; (iii) presenting recommendations to the national essential medicines list committee; (iv) mapping rehabilitation recommendations onto relevant treatment guideline sections; and (v) submitting revised recommendations to the committee for final consideration. The main lesson learnt is that, by working together, rehabilitation professionals can be of sufficient number to make a difference, improve service delivery and increase referrals to rehabilitation from primary health care. A remaining challenge is the lack of a rehabilitation representative on the national essential medicines list committee, which could hamper understanding of rehabilitation and of the complexities of the supporting evidence.