Browsing by Author "Liebenberg, Handri"

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    A description and analysis of the organisational capacity of the rehabilitation services at TC Newman Community Day Centere
    (Stellenbosch : Stellenbosch University, 2014-04) Liebenberg, Handri; Visagie, Surona; Mji, Gubela; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Interdisciplinary Health Scienes. Centre For Rehabilitation Studies.
    ENGLISH ABSTRACT: Rehabilitation services, mainly rendered by therapists employed by the Department of Health, forms a critical part of the Primary Health Care (PHC) package of care. Different policies, within the Department of Health (DOH), provide guidance on rehabilitation service delivery. However, implementation of these policies remains a challenge. The current study aimed to describe and analyse the organisational capacity of rehabilitation services at the study site and to assess how congruent the rehabilitation service at the study site was with existing rehabilitation policy. A descriptive methodology was applied making use of both quantitative and qualitative methods in analyzing the organisational capacity of this study site and the alignment of rehabilitation services offered, with the National Rehabilitation Policy (NRP). The study used the Kaplan framework, the objectives of the NRP and specific selected articles of the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) to develop indicators to be used for the description and analysis of the organisational capacity of the rehabilitation services at TC Newman Community Day Centre. Questionnaires based on seven objectives from the NRP were developed to collect quantitative data from five service providers, the facility manager of TC Newman CDC and the managers of two Non- Governmental Organisations (NGO) working in the drainage site. Face to face, audio recorded, semi- structured interviews were used to collect qualitative data from the five service providers. A folder audit and document review was used to enhance quantitative findings. After analysis of the data, I still felt the need for additional information and thus developed an open ended questionnaire for participants to complete. Barriers (e.g. defaulting of clients, a lack of standard documentation, poor monitoring and evaluation) and facilitators (e.g. outreach and support, competent staff and multi-disciplinary team) were identified in implementing the NRP. Participants highlighted the importance of accessing rehabilitation services with a focus on the outreach to peripheral clinics and funded NGO’s. Intersectoral collaboration is evident, but mainly with funded NGO’s. A lack of standardised documentation, inadequate monitoring and evaluation systems and uniformed documentation were some of the challenges identified by participants. The absence of participation by persons with disabilities was noted by all participants. With reference to the organisational capacity, the participants had a good understanding of rehabilitation within the PHC context. Participants felt confident in delivering rehabilitation services and were able to identify shortcomings in service delivery. It is concluded that rehabilitation services are not delivered exactly in accordance with the objectives of the NRP. However the organisation demonstrated capacity to deliver rehabilitation services at PHC level, but there is still a need to enhance service delivery on community based level. The results of this study gave me as a manager and implementer of health policy in the District Health System the opportunity to gain deeper insight as to how rehabilitation services are currently rendered. Results from the study highlighted how coherent rehabilitation service delivery is with current policy in health and the capacity of the organisation to deliver rehabilitation services. This gave me the opportunity to adjust and review current rehabilitation service delivery and implement changes, as the study progressed.