What policy implementation looks like: implementation of the framework and strategy for disability and rehabilitation in Gauteng, South Africa

Natalie Benjamin-Damons, Sonti Pilusa, Juliana kagura, Naeema Ahmad Ramadan Hussein El Kout
Purpose:

This study aimed to evaluate the implementation of the Framework and Strategy for Disability and Rehabilitation Services (FSDR) in Gauteng, South Africa, addressing barriers individuals with disabilities face in accessing services. It also sought to align the implementation with the EPIS framework to analyze execution and gather stakeholder insights.

Methods:

The study, grounded in implementation science and guided by the EPIS framework, employed a qualitative single-case design to analyze the FSDR's practical application. Using purposive and snowball sampling, 15 semi-structured interviews and six focus group discussions were conducted with diverse stakeholders. Data were analyzed through inductive thematic analysis, revealing key themes and providing insights into successes, challenges, and areas for improvement in rehabilitation services.

Results:

The study identified significant variation in awareness and understanding of the FSDR among stakeholders, with many experiencing limited exposure during education and orientation. This lack of awareness hampers effective implementation, as engagement is essential. Implementation efforts, such as outreach and screening, often lacked formal integration of the FSDR, resulting in confusion and inconsistencies. Staff faced challenges, including high case loads and understaffing, which strained resources and diminished care quality for individuals with disabilities. Additionally, resource shortages, such as inadequate equipment and trained personnel, were major barriers to successful policy implementation. However, effective collaboration among healthcare teams improved service distribution.

Conclusion(s):

The study concludes that effective implementation of the FSDR is hindered by awareness gaps, resource shortages, and coordination issues. For future work, it is suggested to enhance stakeholder awareness, improve resource allocation, and establish standardized practices to strengthen the FSDR's execution and ultimately improve rehabilitation services for individuals with disabilities.

Implications:

The project highlights the need for improved awareness and resource allocation in rehabilitation services, which can inform physiotherapy practice by fostering collaborative approaches, enhancing education on policy implementation, and guiding future policies to better support individuals with disabilities in accessing care.

Funding acknowledgements:
The authors would like to acknowledge the contributions of the South African Society of Physiotherapy
Keywords:
Disability
Rehabilitation
Policy
Primary topic:
Globalisation: health systems, policies and strategies
Second topic:
Disability and rehabilitation
Third topic:
Service delivery/emerging roles
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
The University of the Witwatersrand Human Research Ethics Committee (Medical)
Provide the ethics approval number:
M220364
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
No

Back to the listing