Managers' perceptions on the implementation of community-based rehabilitation in KwaZulu-Natal

S Afr J Physiother. 2024 Jan 26;80(1):1965. doi: 10.4102/sajp.v80i1.1965. eCollection 2024.

Abstract

Background: Community-based rehabilitation (CBR) is a World Health Organization (WHO) strategy for social inclusion, equalisation of opportunities and provision of essential services for people with disabilities (PWDs). Community-based rehabilitation is a multi-sectoral strategy that requires all stakeholders to participate equally in its implementation. KwaZulu-Natal has implemented CBR for over two decades, with various stakeholders at the forefront of implementation. However, the status of stakeholder engagement, collaboration and coordination is unknown.

Objective: The objective of our study was to understand how CBR is implemented in KwaZulu-Natal and the roles of each stakeholder in its implementation, with a focus, on managers from government and non-governmental organisations.

Method: A descriptive explorative approach using semi-structured interviews was used to collect data from 20 managers from various stakeholders involved in implementing CBR in KwaZulu-Natal. Data were transcribed and analysed using thematic analysis.

Results: The findings revealed five dominant themes: (1) the understanding of concepts, (2) missed opportunities for implementing CBR, (3) barriers to implementing CBR, (4) benefits to implementing CBR and (5) recommendations for future implementation.

Conclusion: A formal management structure with clear roles and responsibilities was fundamental for implementation. Collaboration, coordination and planning were believed to be the critical roles of managers in the implementation of CBR. Training, awareness and sharing of resources among stakeholders were also identified as important factors in implementing CBR in KwaZulu-Natal.

Clinical implications: Our study will assist managers and clinicians to improve their planning and implementation of CBR.

Keywords: CBR managers; CBR workers; collaboration; community-based rehabilitation; disability; people with disabilities; rehabilitation; stakeholders.

Grants and funding

Funding information The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the National Research Foundation (NRF) [grant no.: 129422] and Development Research, Innovation, Localisation and Leadership in South Africa DRILL for the research, authorship and/or publication of this article.