Centre for Disability and Rehabilitation Studies
Permanent URI for this community
Browse
Browsing Centre for Disability and Rehabilitation Studies by browse.metadata.advisor "Mji, Gubela"
Now showing 1 - 11 of 11
Results Per Page
Sort Options
- ItemAccess to primary care for persons with spinal cord injuries in the greater Gaborone, Botswana(Stellenbosch : Stellenbosch University, 2018-03) Paulus-Mokgachane, Thato Michael Moutie; Visagie, Surona; Mji, Gubela; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Global Health. Centre for Rehabilitation Studies.ENGLISH SUMMARY : Introduction: People with SCI often have great need for health care services, but they report access challenges. Primary care access to people with SCI has not been explored in Botswana. Aim: This study aimed to identify barriers and facilitators that users with spinal cord injuries experience in accessing primary care services in the greater Gaborone. Methods: A quantitative, cross sectional, observational study was done. Data was collected with a structured questionnaire from 57 participants with traumatic and non-traumatic SCI. Descriptive analysis was done. Results: The male to female ratio was 2.8:1. The mean age of participants was 40 (SD 9.59). Road traffic accidents caused 85% of the injuries. Most participants visited primary care facilities between 2 to 10 times in the six months before the study. Participants were satisfied with the services (63%) and felt that facilities were clean (95%) and well maintained (73.5%). Preferential treatment, respect, short waiting times and convenient hours facilitated an acceptable and adequate service. Availability was hampered by insufficient provider knowledge on SCI as indicated by 71.9% of participants, and shortage of consumables (80.7%). Structural challenges (42.1% could not enter the facility by themselves and 56.5% could not use the bathroom) and lack of height adjustable examining couches (66.7%) impeded accessibility. Cost was incurred when participants (64.9%) utilised private health services where public services failed to address their needs. Conclusion: Primary care services were mostly affordable, acceptable and adequate. Availability and accessibility aspects created barriers.
- ItemA case study exploring community inclusion of adults with intellectual disabilities who participate in/attend protective workshops in Cape Town(Stellenbosch : Stellenbosch University, 2024-03) Pitt, Catherine; Geiger, Martha; Kahonde, Callista; Mji, Gubela; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Rehabilitation Studies.ENGLISH SUMMARY: Research shows that persons with intellectual disabilities (ID) are the most marginalized group among persons with disabilities in South Africa. Despite the progress in this country towards an inclusive and free country, persons with ID are not experiencing their full citizenship. Although South Africa signed and ratified the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) almost two decades ago, persons with ID still have limited access to services that can facilitate their inclusion into communities. Some progress has been made in education with children with ID, but little progress has been made towards the inclusion of adults with ID into employment and community activities. Furthermore, they are seldom included in research even when the research seeks to understand their day-to-day experiences. This study therefore set out to explore the community inclusion opportunities and aspirations of persons with ID attending a protective workshop in Cape Town. This study used a case study methodology within a constructivist paradigm to explore the participants’ aspirations and opportunities for community inclusion. Methods of data collection were carefully selected and planned to ensure meaningful inclusion of the participants in the data collection process. The methods included interviews, focus groups, community mapping and field notes, which were supported by tools like pictures, icons, games, community maps and repetition of the questions and discussions. An analysis of secondary data was also conducted to seek further understanding of the study context and confirm the findings from other sources of data. Twenty-eight adults with ID within the age range of 21 and 54 years, recruited from two protective workshops, participated in the study. The data was analysed using thematic analysis and four themes were generated, namely; what I do in my community, what I want from independence, the significance of relationships, and the importance of work. Their inclusion opportunities in their community ranged from assisting in their homes, and participating in community activities and hobbies and the importance of work in achieving their experience of independence and relationships was described. The participants aspired to be included in more activities independently, understanding the barriers that their impairment and the context presented. Possible supports were identified to overcome their barriers. The findings demonstrate that with appropriate support available, persons with ID are capable of contributing meaningfully to their communities. This disrupts the status quo of myths and stereotypes about persons with ID that marginalize them. The participants grappled with the conflict of their desire for independence versus their identified vulnerability. Further, they described the variety of relationships that they find to mitigate loneliness. Finally, work was described as a facilitator of inclusion. These findings can inform policy developers to effect changes to service provision to establish supports for persons with ID to be included in their communities. Emerging from these findings was a possible tool of community inclusion which aligns the environment with the supports of persons with ID to facilitate inclusion in the activities of their own choice.
- ItemExperiences of persons with disabilities of Xhosa rituals and traditions, which contribute to health and wellbeing(Stellenbosch : Stellenbosch University, 2023-03) Dwadwa-Henda, Nomvo; Mji, Gubela; Ohajunwa, Chioma; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Rehabilitation Studies.ENGLISH SUMMARY: The disability scholarship has always been dominated by Western literature (1)(2)(3)(4) which locates disability on the person and presents it as a tragedy without considering contextual factors which contribute to the various understandings of disability by people of the South. With a paucity of literature on disability by African scholars, some literature on disability in Africa is most of the time presented by people from the North who leave out the situations and things that existed in the past and are part of the people’s history – this is a missed opportunity on important aspects of disability of Indigenous peoples. The study explored the Xhosa rituals and traditions of Bomvana people (an Indigenous community in the Eastern Cape Province of South Africa) from birth to adulthood, and how persons with disabilities experienced these rituals. The study also explored the contribution of these rituals to the health and wellbeing of the person. Factors that contributed towards building a collective disability framework that is centred around the worldview of AmaBomvana for the health and wellbeing of the community were also explored. Data gathering methods included an exploratory case study with persons with disabilities, focus group discussions with knowledge holders, observations, one-on-one in-depth interviews, journaling, and informal conversations. Sampling of participants from the three Gusi village clusters comprised of 50 participants. Content analysis was used with the text divided into meaningful units – guided by the study aim and the research questions. The PhD study findings presented conceptualisation of disability by AmaBomvana, which demonstrated that their Indigenous worldview plays a role in how they interpret the world. Their understanding of disability is in contrast with Western approaches, and carries respect and dignity, which attests to their ancestral reverence – whereby spirituality takes precedence to the physical. Hence their disability ontology is quite unique and comforting. Ubuntu as the Bomvana guiding principle serves to examine and guide justification for their moral judgements in their community. The study concluded by proposing a disability framework that is modelled on collectivism which continues to express Ubuntu philosophy as principle.
- ItemAn 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.
- ItemAn exploration of lower limb prosthetics service delivery in Namibia in comparison to global standards(Stellenbosch : Stellenbosch University, 2023-03) Likando, Christopher Mubita; Visagie, Surona; Mji, Gubela; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Rehabilitation Studies.ENGLISH SUMMARY: Background: In 2017, the World Health Organisation published prosthetics and orthotics standards that are aimed at improving prosthetics and orthotics services internationally. The standards are meant to assist member states to improve prosthetics service delivery. The prosthetics standards document calls for the comparison of “the national prosthetics systems and services with the complete set of standards to derive a baseline against which to monitor further development” (WHO, 2017: xxi). Aim: The aim of this study was to explore the status of lower limb prosthetics service delivery in the public healthcare system of Namibia and compare it against the World Health Organisation`s global standards for prosthetics and orthotics. Methods: A sequential mixed methods design was adopted for this study where qualitative (descriptive) and quantitative (cross-sectional survey) data were collected and analysed sequentially. The study was carried out in Namibia's Khomas (urban) and Oshana (rural) regions. Insufficient records necessitated non-probability sampling in both settings and phases. Qualitative data were collected through semi-structured interviews with two service managers, nine service providers, and 16 prosthetics service users guided by interview schedules. Quantitative data were collected from two service managers, ten service providers, and 120 lower limb prosthetics service users. A survey was developed for managers and providers while users completed the TAPES-R. Content analysis was used for the qualitative data. The 60 standards provided deductive themes. Quantitative data was mainly analysed descriptively. Data from the two phases was triangulated and presented together. Findings: Findings showed that 12 of the 60 standards were implemented in Namibia. A further 28 were partially adhered to, while 20 were not implemented at all. Namibia had national policies that guide prosthetic service delivery, but the policies were outdated and not well adhered to. The study established that funding was available but insufficient. There was a wide range of prosthetics products available at no cost to users. Users’ needs were mostly met by available prosthetic products except for the ability to perform vigorous activities and participate in sports, which were limited for 90.8% (n=109) and 87.5% (n=105) of users respectively. Service users 82.6% (n=99) were satisfied with their prosthetic devices and the prostheses allowed them to be economically active 75.0% (n=90). Service providers were well-trained but did not regularly participate in continuous professional development. Training to qualify as a prosthetics service provider was not available in Namibia and in-service training opportunities were scarce. The number of service providers was insufficient. Lower limb prosthetics services were provided to all in need but often this involved long travel distances (mean 258.38 km; sd 265.611) as services at the primary level were not readily available. Users were not involved in policy development and implementation. Experienced users had the choice of products and providers, but first-time users did not. Users were provided with training, follow-up, and repairs. There was little collaboration with other team members during prosthetic rehabilitation. Conclusion: The study showed that more efforts are needed toward improving the delivery of lower limb prosthetics services in Namibia and upgrading them to levels that are in accordance with the World Health Organisation standards. It was concluded that a systems approach, based on the ten ‘Ps’ of systems thinking in assistive technology, could be adopted as a conceptual framework to identify interventions that can be most effective and efficient in efforts to meet the required standards.
- ItemAn exploration of the development of community health forums as a strategy to improve communication between biomedical health professionals and an indigenous community : a rural participatory action research study(Stellenbosch : Stellenbosch University, 2021-12) Gxamza, Faniswa Desiree; Mji, Gubela; Reid, Steve; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Rehabilitation Studies.ENGLISH SUMMARY : Rationale: Firstly, the existence of nine (9) clinics and a district hospital in Bomvaneland has been seen by people of this area as both a blessing and a problem as there is poor communication between allopathic health workers and the indigenous community. Allopathic health practitioners (AHP) chastise and marginalize patients who have used indigenous health (IH) prior to visiting allopathic healthcare services. Secondly, the complexity of understanding IH and that indigenous people have a concept of health that is eco-social and often communal, rather than individual. Thirdly, there is lack of institutional spaces where both indigenous knowledge system (IKS) and allopathic healthcare could be discussed for promoting wellness and quality of life of Bomvane people. Aim and Objectives: The study explored and described the development of a Community Health Forum as a strategy to improve communication between allopathic health practitioners and an indigenous community. The main study objectives were to explore and describe: • The process of establishing relationships and development of community partnerships. • Development of community health forums as a strategy to improve communication between allopathic health professionals and an indigenous community. Method: The main methods for data collection were ethnographic and participatory action research (PAR). Using participatory action research in cycles of reflection, the study covered four phases (1-4) to gain consensus on the main aim of the study, study objectives and data collection methods. During community entry and the three conferences (2016, 2018 and 2019), key community stakeholders from the nine (9) sub-municipalities of the research area participated. Mji’s critical research findings were used as a tool to initiate communication. Phase 5 focused on the development of a community health forum and data was collected from four sub-municipalities (Xhora, Gusi, Hobeni and Nkanya). Purposive and snowball sampling was used to select n=37 study participants (12 being allopathic health practitioners, eight indigenous healers and 15 community members). Data-gathering methods for phase 5, included focus group discussions, in-depth interviews, (Chilisa, 2012), journaling and photography. Phase 6 was the last method of data collection which was a conference in 2019 to pilot a community health forum. Findings: The study findings further affirmed the earlier propositions of challenges of communication and poor relationships between allopathic and indigenous health practitioners. When sick, the indigenous community uses both the indigenous and allopathic health practitioners. Some attempts had been made to improve these poor relationships by introducing a referral system, unfortunately this attempt was still not sufficient as it appears only the indigenous health practitioners refer their patients to allopathic health practitioners. This caused indigenous health practitioners to feel they are still not trusted by allopathic health practitioners. An outline was given by participants on the nature of future communication, including a framework that will drive the communication process between allopathic and indigenous health practitioners. At the core of this outline is a need for the communication process to be underpinned by respect for each other’s human dignity. One of the major findings of the study is the development of an Interim community health forum which was achieved in Phase 6 of this study. Mji’s critical research findings further affirmed negative social determinants of health (NSDH) that were blighting AmaBomvane. Unfortunately, it appears that with passage of time these had become worse with fighting of children and sickly older males suffering from ailments due to working in the mines. What gave hope out of this concerning situation is the draft MOU that was developed by the indigenous health practitioners. Within this MOU are guiding principles which are positive social determinants of health (PSDH) to support AmaBomvane to turn around the NSDH to PSDH. Conclusion: The dual health-seeking behaviour of AmaBomvana should not be seen in a negative light by allopathic health practitioners, instead they should try to understand more about indigenous health and its practises. The chastising of indigenous patients when they have consulted indigenous healers results in the silencing of indigenous patients. Communication is at the core of proper diagnosis and subsequent care for the sick patient. The paradigmatic differences that exist between allopathic and indigenous health practitioners might need time to be resolved. The community health forum seems to offer a bridge for these two constituencies to work together in a respectful manner despite their differences. These two healthcare systems need to acknowledge their different practices and come to a realisation that working together may not be possible but working in parallel and focusing on certain areas, such as social determinants of health, would improve the health of Bomvane people. In the wake of Covid-19 Pandemic, the suggested model (CHF) is a way forward for the area.
- ItemAn exploration of work-related stress and support structures experienced by occupational therapists working at a physical rehabilitation unit(Stellenbosch : Stellenbosch University, 2016-03) Clarke, Jennifer; Visagie, Surona; Mji, Gubela; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Interdisciplinary Health Sciences. Centre for Rehabilitation Studies.ENGLISH ABSTRACT: Introduction: Work-related stress is experienced in most working environments but can be particularly high in health-care environments. Support structures can help to alleviate the burden of work-related stress, but whether or not these structures are in place and adequate needs exploration. Aim: To explore and describe the work-related stress experienced by occupational therapists working at a physical rehabilitation unit and to determine whether the current support structures are addressing the work-related stress that they experience. Methods: This study was qualitative in nature. A phenomenological approach was used. Seven occupational therapists employed at the study setting were interviewed using semi-structured methods. Data was collected, transcribed and analysed by the researcher, and themes and sub-themes were extracted. Findings: All of the participants were experiencing quite high levels of work-related stress, mainly due to the nature of the work environment and challenges related to management and supervision. Other causes of stress were problems related to caseload, the role of the occupational therapist (OT) in the team, issues related to their colleagues and qualitative versus quantitative care delivery. The study also revealed that the participants were not satisfied with the support structures that were in place and had recommendations as to how the support structures could be improved to reduce work-related stress. Conclusion: The findings of the study confirmed the need for more effective support structures. Participants were quite vocal about the amount of stress and the lack of support they were experiencing – to the extent that they had to find alternative means of support. It was felt that management should show more awareness through acknowledging the therapists’ experiences, and that the organisation should put better support structures in place. Recommendations: Individual counselling, team building and group therapy sessions were recommended, as was decreasing the extent of responsibilities over-and-above the core job requirements or having smaller caseloads or more staff. Stellenbosch University https://scholar.sun.ac.za iv Among the many suggestions regarding managerial improvements were that managers should be more aware of the staff, help with the patients and be more empathetic. Improved communications through all levels of the Centre and a more representative measure of performance was also suggested.
- ItemExploring barriers and facilitators to return to work for clients with spinal cord injuries, in Cape Town, South Africa(Stellenbosch : Stellenbosch University, 2018-03) Ngemntu, Sharon Nokuzola; Mji, Gubela; Ned, Lieketseng; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Global Health. Centre for Rehabilitation Studies.ENGLISH SUMMARY : Background: Spinal cord injury is a catastrophic event, characterised with loss of function below the level of the lesion and increased dependence on family and societal support. The researcher has been working as an Occupational Therapist in a centre for physical rehabilitation of clients with physical impairments, including those with spinal cord injuries, for more than five years. She has observed that only a small percentage of clients with spinal cord injuries that have completed their rehabilitation programme were able to go back to work after the injury. After examining statistics of the clients seen in the period January-December 2001, when working at a local tertiary Hospital’s Work Assessment Unit in February 2014, the researcher was then further motivated to explore barriers and facilitators to return to work for clients with spinal cord injuries. Hence the aim of this study is to explore barriers and facilitators to return to work for clients with spinal cord injuries. Method: A qualitative study design was implemented to explore views of clients, managers/supervisors of clients with spinal cord injuries and rehabilitation professionals with regard to barriers and facilitators to return to work of clients with spinal cord injuries. Semi-structured interviews were conducted with 13 participants, including clients with spinal cord injuries, a manager of one of the persons with disabilities participating in the study, and Occupational Therapists involved in physical rehabilitation (including rehabilitation of persons with spinal cord injuries) or vocational rehabilitation (work assessment or return to work). Interview schedules were used to conduct interviews, which were recorded and later analysed thematically. Results: The findings highlighted return-to-work barriers related to inaccessible and non-supportive environment, the employers’ attitudes, injury-related issues, the challenging job demands of the previous work as well as transport issues. The facilitators indicated were provision of assistance and support (received from family, friends, church and work); the role of rehabilitation and rehabilitation team members and other role players as well as the necessity of reasonable accommodation in successfully reintegrating persons with spinal cord injuries. Triangulation was done and two common themes emerged amongst the three groups of participants (clients with spinal cord injuries, Occupational Therapists and the Manager) and these indicated the support received by persons with spinal cord injuries and the process of reasonable accommodation which facilitated integration to work. Conclusion: The study findings indicated a need for support for persons with spinal cord injuries, making sure the environment is accessible or conducive for return to work, putting reasonable accommodation measures in place and involvement of all stake holders in the successful reintegration of persons with spinal cord injury to work. These measures could assist all stake holders involved in understanding the needs of persons with spinal cord injury, the responsibility of each of the stakeholders and knowledge about available resources in fostering a smooth transition back to work for spinal cord injury clients.
- ItemReconnecting with Indigenous knowledge in education : exploring possibilities for health and well-being in Xhora, South Africa(Stellenbosch : Stellenbosch University, 2019-04) Ned, Lieketseng Yvonne; Mji, Gubela; Ramugondo, Elelwani; Devlieger, Patrick; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Rehabilitation Studies.ENGLISH SUMMARY : Owing to coloniality, Eurocentric and western thinkers have been privileged in knowledge production while African indigenous thinkers and knowers have been subjugated. Consequently, western knowledge has been described as universal knowledge, while indigenous people’s knowledges remain characterized as backward and primitive. In this arrangement, the current education system reproduces inequities of knowledges. How this knowledge arrangement influences the persisting negative health status among indigenous people, and the role of formal schooling in this, remains unexplored in South Africa and beyond. There is a need to explore and describe from the perspectives of indigenous people the potential relevance of indigenous knowledges in transforming the formal education system for better health and well-being. Using case study design supported by narrative inquiry as methodological frameworks, I facilitated a case of narratives with AmaBomvane in Xhora (Eastern Cape province, SA) to: • describe AmaBomvane’s rural experience of the influence of the formal education system on their Indigenous traditions and knowledges and their links to health and well-being; • explore what stakeholders in these communities (elders, youth and teachers) identify as some of the Indigenous knowledges and ways of teaching and learning; and • explore how the identified knowledges and teaching and learning strategies of AmaBomvane can inform curriculum development and implementation in the formal schooling system. The case study provided contextual boundedness and situatedness to the research, while narrative inquiry uncovered the stories that formed the basis for exploring and describing the case in question. The participants played an active role in guiding the research process. Indigenous methods (talking circles and storytelling using the sagacity approach) were used to collect narrative, primary data from residents of four sampled villages. In-depth interviews with teachers and principals from schools across the villages and other methods such as researcher observations and spontaneous conversations were used. The sagacity approach, reflexivity, reciprocity and continuous relationship-building grounded these methods. A case of seven co-constructed narratives highlighted three typologies (Amaqaba, Amagqobhoka, and Agonizers: the uncomfortable in-betweeners) related to the complex interactions and dynamics between formal schooling and the communities and/or homes. These typologies reveal the intersecting operations of coloniality of power, being, knowledge and doing. The literacies of AmaBomvane challenge the academy by bringing considerable insight into our understanding of knowledge itself, learning and the purpose of education and curriculum. The inseparable link between everyday doing, knowing and being was highlighted as central to knowledge production. AmaBomvane’s conceptualization of knowledge also highlighted an inextricable link between health and education, thus advocating for an education that enhances living well. In conclusion, colonial education emerged as a potential negative social determinant of AmaBomvane’s health as it produces people who are deeply alienated from themselves, their lands, cultures, ancestors, languages and knowledges. Its historical roots, forced assimilation and the unquestionable characteristic of curriculum create a colonising attitude amongst learners and educators. I therefore argue that coloniality and colonial education be recognised as broader social determinants of ill health. I argue that centering indigenous knowledges and cultures within the formal schooling curriculum may contribute to strengthening positive indigenous identities, thus contributing to better physical, social, mental, emotional and spiritual health and well-being. There is an urgent need to prepare educators who are socially conscious and competent to facilitate a health-enhancing curriculum that enables learners to live well. Given the revealed inextricable link between health and education, I also recommend that South African national curriculum immerse health and well-being as a core area of learning. I have thus developed an indigenous-decolonial framework for reconstructing curriculum for health and well-being as a guide.
- ItemSuitability of ‘Guidelines for screening of prosthetic candidates: lower limb’ for Eastern Cape(Stellenbosch : Stellenbosch University, 2017-03) Mduzana, Luphiwo Lakhanya; Visagie, Surona; Mji, Gubela; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Rehabilitation Studies.ENGLISH SUMMARY : Background: Major lower limb amputation has a severe impact on functional mobility. While mobility can be salvaged with a prosthesis, it is not always the most optimal choice. It is often difficult to decide whether to refer someone for a prosthesis. An evidence-based prosthetic screening tool ‘Guidelines for Screening of Prosthetic Candidates: Lower Limb’ is used for prosthetic prescription in the Western Cape Province of South Africa. Objectives: The study aimed to explore the suitability of the tool ‘Guidelines for Screening of Prosthetic Candidates: Lower Limb’ for use in the Eastern Cape Province of South Africa. Method: A qualitative study was conducted with conveniently sampled occupational therapists (n=10), physiotherapists (n=12) and medical orthotists/prosthetists (n=6) in government employment in the Buffalo City Metro Municipality. Participants were trained to use the tool and then used it for four weeks. Their experiences of the tool were assessed through three focus group discussions. Emergent themes were identified during analysis. Findings: Participants indicated that the tool could assist with prosthetic prescription, goal setting, communication and teamwork. They thought the tool was multidisciplinary in nature, comprehensive and practical. Findings showed challenges with regard to teamwork in the study setting. Resistance to change and a lack of time might hamper implementation of the tool. Participants suggested a longer test period, with structured feedback sessions, and supported by hospital management. Conclusion: The tool can assist with managing the backlog for prostheses and to guiding prosthetic prescription in the Eastern Cape Province.
- ItemUnderstanding, interpretation and expression of spirituality and its influence on care and wellbeing : an explorative case study of a South African indigenous community(Stellenbosch : Stellenbosch University, 2019-04) Ohajunwa, Chioma Ogochukwu; Mji, Gubela; Kalenga, Rosemary; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Rehabilitation Studies.ENGLISH SUMMARY : With the historical entrance of western spirituality and healthcare into Africa, and the philosophical frameworks they embody, tensions have been created within South African indigenous contexts that impact negatively on the social determinants of health and community wellbeing. Indigenous South African communities assert that western healthcare and spirituality have sidelined their indigenous spiritual practices. This sidelining has created divisions within the community which have informed this case study and the need to explore spiritual understandings that contribute to a collective wellbeing for this community. This study is focused on exploring the ways that indigenous communities understand, interpret and express their spirituality and how these ways of seeing spirituality influence care and wellbeing. The study also aims to explore what factors can contribute to building a collective spirituality framework that contributes to community wellbeing. The study is positioned within a constructivist interpretive paradigm using an exploratory ethnographic case study approach. Data-gathering methods include focus group discussions, observations, one-on-one in-depth interviews, opportunistic conversations (Chilisa, 2012), journaling and photography. Purposive sampling with n=52 study participants from the four Gusi village clusters of the Elliotdale district in the Eastern Cape was carried out. An analytical strategy of theoretical propositions (Yin, 2009) stemming from the guiding proposition and research questions guided the analysis. The Bomvana communities understand spirituality as a multi-level process that involves caring relationships within all of nature. These understandings are influenced by history, context and access to spiritual resources to position the four communities within the subliminal, liminal and supraliminal spaces on a continuum of wellbeing, supporting cultural disruption or supporting cultural continuity to influence wellbeing. The first community still resides within the ideal spirituality space at the start of the continuum although it is beginning to move towards the liminal space, while the other three communities have moved on the continuum into the liminal spirituality space. The communities are experiencing tensions and a lack of wellbeing due to the different ways of expressing their spiritualities. Narratives of participants regarding Ubuntu are utilised to build a thesis on an understanding of African Indigenous Transcultural Spirituality to inform wellbeing. This concept is proposed as a collective spirituality framework that has the potential to support a community-led approach when engaging with African indigenous communities.