Rehabilitation in community-orientated primary care: Perspectives of rehabilitation therapists in the Western Cape province, South Africa

Abstract

Introduction: In South Africa, the national policy on re-engineering primary health care supports the implementation of nurse-led, ward-based outreach teams with community health workers. The Western Cape Department of Health uses community orientated primary care (COPC) as as implementation framework for the improvement of primary level district health services. Ward-based outreach teams of rehabilitation care workers (RCWs) led by rehabilitation therapists were implemented in two peri-urban health sub-districts to introduce rehabilitation in COPC.

Method: A collaborative enquiry was implemented with members of the primary level team to explore the contribution of these rehabilitation teams to COPC. Qualitative descriptive data were collected during three narrative action reflection workshops. Data were deductively coded and categorized using the principles and elements of COPC.

Findings: Enablers and barriers to rehabilitation at primary level were identified and actions aligned with COPC highlighted.

Discussion: The inclusion of rehabilitation in COPC will require health system planners to apply broader conceptual frameworks inclusive of disability and support capacitation of mid-level rehabilitation workforce. 

Conclusion: Rehabilitation therapists and RCWs are essential contributors to COPC. This should be considered during human resource planning for universal health coverage and national health insurance.