Category: Health Policy and Systems
Rehabilitation assists persons with disabilities attain physical independence and self-determination. Rehabilitation services in rural uThungulu District, KwaZulu-Natal, South Africa are covered by public sector which is limited, with physiotherapists working in multidisciplinary teams. Consequently, achieving rehabilitation goals of functional independence is affected. Public and private rehabilitation service providers working together can help to combat this problem.This study explored current knowledge, attitude, rehabilitation service practices in uThungulu and possibility of Public Private Partnerships (PPPs).
Sample of 50 (37 public, 13 private) rehabilitation service providers were interviewed; using mixed methods exploratory case study. Using focus groups, individual interviews and questionnaires, information on their perception of availability, accessibility and equitability of rehabilitation services was requested.
Practitioners reported poor rehabilitation service provision due to poor socio-economic circumstances, limited multidisciplinary rehabilitation and poor service delivery. 64% reported that rehabilitation was not sufficient, 92% reported working in multidisciplinary teams with human resource shortages. 69% reported non-availability of designated rehabilitation units. Professionals in rehabilitation units evaluated the effectiveness of rehabilitation programme significantly more positively than those without designated units (U= 98.5, p=0.01). Positive correlation found between participants’ perceptions of managerial support and perceived rehabilitation programme effectiveness (rs= 0.45, p=0.01). A weak, positive, statistically significant correlation between perceived effectiveness of rehabilitation programme and ease of administrative process was found (rs= 0.29, p= 0.04). Two thirds (66%) did not know about PPP, only a third (34%) knew about it.
Rehabilitation service in uThungulu is provided in hospital departments and less so at community-based centres (clinics). Rehabilitation services are multidisciplinary but were perceived negatively due to lack of equipment, absence of designated rehabilitation units, human resource shortages, lack of managerial support and cumbersome administrative processes. Most providers were not aware of PPPs. Providers aware of PPPs reported a positive potential for PPPs as vehicles of rehabilitation service provision.