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

De Wet, Caroline (2014-04)

Thesis (MHumanRehabSt)--Stellenbosch University, 2014.

Thesis

ENGLISH ABSTRACT:Background In the past, a lack of policy guidelines in the area of rehabilitation often resulted in underdeveloped or no rehabilitation services in many areas. This led to the development of The South African National Rehabilitation Policy (NRP) which was finalised in 2000. This policy is guided by the principles of development, empowerment and the social integration of persons with disabilities. It aims to provide improved access to rehabilitation services for all and 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 on equalisation of opportunities for people with disabilities and their inclusion in development. Aim The aim of thestudy was to describe and analyse the organizational framework of rehabilitation services at the Gugulethu Community Health Centre (CHC) in Cape Town and to determine if the framework used complied with the objectives of the National Rehabilitation Policy. Method This was a case study that made use of both qualitative and quantitative methods of data collection. The Kaplan framework, the objectives of the NRP and the five relevant articles of the UNCRPD were used to design three questionnaires for data collection. The first questionnaire was for service providers and answered by seven participants. The second questionnaire was completed by the Facility Manager of Gugulethu CHC and the third questionnaire 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 and the facility manager as well as from two focus groups held with service users. Results The results of the study showed that there was some coherence between the rehabilitation services provided and the objectives of the NRP such as good access to the service for clients 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 of intersectoral collaboration was found. There was no evidence of the inclusion of persons with disabilities in the planning, implementation and managing of rehabilitation services. Similarly services were not monitored and evaluated in a constructive way and while the therapists did engage in skills development activities the suitability of the courses attended for their role is questioned. Conclusion The findings showed a facility based curative rehabilitation service that was accessible for clients who came to the facility, but did not expand to provide community based rehabilitation. Thus it was concluded that the organisation in its current form lacked the ability to effectively address the needs of the community that it served. At Gugulethu Community Health Centre rehabilitation services need to be planned according to community based rehabilitation strategies by the manager, the service providers and the community. Only when implementation of the NRP and UNCRPD takes place will the benefits become tangible to the entire community. Key Words Rehabilitation, Disability, National Rehabilitation Policy, UNCRPD, Organisational capacity.

AFRIKAANSE OPSOMMING: Agtergrond In die verlede het ‘n gebrekaanbeleidsriglyne in die rehabilitasievelddikwelsgelei tot onderontwikkelde of geenrehabilitasiedienste in baiegebiede. Die gevolghiervan was die ontwikkeling van dieSuidAfrikaanseNasionaleRehabilitasieBeleid (NRB) wat in 2000 gefinaliseer is. Die fokusvan hierdiebeleid is ontwikkeling, bemagtiging en die sosialeintegrasie van persone met gestremdhede. Die doel van die NRB is omtoeganklikheid van rehabilitasiediensteviralmalteverbeter en ditvormdeel van die strategieom die lewensgehalte van persone met gestremdhede to verbeter. SuidAfrika het die VerenigdeNasies se Konvensievir die Regte van Persone met Gestremdhede in 2001 bekragtig. HierdieKonvensie is ‘n internasionaleregsgebaseerdedokument and fokus opgelykeregtevirpersone met gestremdhede en hulinsluiting in ontwikkeling. Doelstelling Die doel van die studiewas om die organisatorieseraamwerk van die rehabilitasiedienste by die GugulethuGemeenskapsGesondheidssentrum in Kaapstadtebeskryf enteontleed, ten eindevastestel of die raamwerk, in ooreenstemming is met die doelwitte van die NasionaleRehabilitasieBeleid. Metode `n Gevallestudie is gedoen. Data is deurmiddel van kwantitatiewe en kwalitatiewemetodesingesamel. Die Kaplanraamwerk, doelwitte van die NasionaleRehabilitasieBeleid en toepaslike 5 artikels van die VerenigdeNasie se Konvensievir die Regte van Persone met Gestremdehede is gebruikomdrievraelysteteontwerp. Die eerstevraelys was virdiensverskaffers en sewedeelnemers het ditbeantwoord. Die tweedevraelys is deur die Fasiliteitsbestuurder van GuguletuGemeenskapsGesondheidssentrumbeantwoord en die derdevraelysdeur twee bestuurders van twee doelbewustegekoseNie-staatsOrganisasies in Guguletu. Onderhoude is met drie van die diensverskaffers en die fasiliteitsbestuurdergebruikomkwalitatiewe data in tesamelsowel as twee fokusgroepe met diensverbruikers.Resultate Die resultate van die studietoondatdaarwel ‘n mate van belyningtussenrehabilitasiedienste by die studiesentrum en die doelwitte van die NasionaleRehabilitasieBeleid is. Ditsluit in goeietoeganklikheidna die diensvirklientewat die sentrumbesoekvirbehandeling en voldoendebronneomhulpmiddelstevoorsien.In andergebiede was daaregter min of geenbelyningnie. Daar is min bewyse van intersektoralesamewerking en geenbewyse van die insluiting van persone met gestremdhede in die beplanning, implementering en bestuur van die rehabilitasiedienstenie. Dienste is nie in ‘n opbouendemaniergemonitor of geevalueernie en terwyl die terapeutewelaanontwikklingsprogrammedeelgeneem het, kan die toepaslikheid van die kursussebevraagteken word. Gevolgtrekking Die bevindingswys op ‘n kuratiewerehabilitasiedienswattoeganklik is virklientewatna die sentrum toe kom. Daar word egterniegemeenskapsbaseerderehabilitasieverskafnie.Dus, is die gevolgtrekkingdat die organisasie in syhuidigevormnie die vermoe het om die behoeftes van die gemeenskapwatditdien, effektiefaantespreeknie.Dierehabilitasiedienste by GuguletuGemeenskapssentrummoetbeplan word volgensgemeenskapsgebaseerderehabilitasiestrategiee, deur die bestuurder, diensverskaffers en die gemeenskap. Eerswanneer die NasionaleRehabilitasieBeleid en die VerenigdeNasie se Konvensievir die Regte van Persone met Gestremdhedetoegepas word sal die helegemeenskapbaatvind by rehabilitasie.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/86418
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