This study aims to determine the functioning priorities of persons with chronic SCI in South Africa, focusing on health system indicators, social factors, and quality of life to inform healthcare service planning.
A cross-sectional survey was conducted in four South African provinces, recruiting adults with chronic SCI through hospital registries and a non-profit organization. Participants completed a comprehensive self-report assessment covering demographics, injury characteristics, secondary medical conditions, environmental factors, healthcare utilization, and quality of life.
The study enrolled 314 participants, predominantly male (75%) and aged 31-45 (43%). Most have paraplegia (67.5%) and long-standing injuries (43% over 16 years). Only one-fifth are employed, with many relying on disability pensions (73.9%). While vocational rehabilitation was received by 58.3%. Medical supplies and support services show mixed results, with about half facing challenges in access. Environmental barriers significantly impact daily life, with inaccessible public spaces (72.1%), friends' homes (69.2%), and lack of transport (74%) being major issues. Societal attitudes vary, with negative public perceptions affecting 56.4%, while family and friends are generally more supportive. Financial strain is the most significant factor, affecting 79.7%. Communication devices are generally sufficient, but state services are seen as inadequate by 67.9%. Quality of life measures reveal a complex picture. General quality of life, health satisfaction, and satisfaction of oneself split between positive and negative responses. However, more respondents report dissatisfaction with living condition (53.5%). This could reflect challenges in adapting living spaces to accommodate spinal cord injury-related needs
This study reveals significant challenges for individuals with spinal cord injuries in South Africa, including high unemployment, financial strain, and limited access to medical supplies and support services. Environmental barriers in public spaces and transportation severely restrict daily activities and social participation. While family support is generally positive, negative public attitudes persist. The mixed quality of life results reflects the complex interplay of personal, social, and environmental factors. Addressing these issues requires a multi-faceted approach, including improved healthcare services, enhanced vocational rehabilitation, and interventions to reduce environmental barriers. Policy makers and healthcare planners should prioritize these areas to improve the overall quality of life and social integration of individuals with SCIs.
The study highlights the need for improved healthcare services, vocational rehabilitation, and accessible environments for individuals with spinal cord injuries in South Africa. Policymakers should prioritize reducing financial strain, healthcare planning should focus on holistic care, enhancing medical supply access, and addressing societal barriers to improve quality of life and social inclusion.
Social Factors
Quality of life
