Capacity of the SA public health sector to deliver rehabilitation services: an institutional analysis

Abstract

International and national discourses on disability conclude that rehabilitation is a fundamental concept in disability policies and is seen as the process without which many people with health problems leading to impairment and/or disability would not be able to participate fully in society (1). While successful health outcomes for doctors and nurses are measured in how many lives are saved and how many people remain healthy, successful rehabilitation outcomes are judged by the level of integration into mainstream society of people with residual impairments. Social integration is impossible to achieve without effective rehabilitation service delivery. Despite a progressive and enabling legislative framework in South Africa (SA), services for people with disabilities (PwD) somehow are not meeting the needs of both adults and children with disabilities in SA, as demonstrated through continued poor socio-economic status. Emerging evidence that the public health sector is struggling to provide effective, efficient and equitable rehabilitation services, requires due attention to be paid to understanding what these capacity constraints are from a provider perspective.