Development of a model for the rehabilitation of children with disabilities in the greater Giyani Municipality in Limpopo Province, South Africa

Abstract

The rehabilitation of children with disability (CWDs) in a rural area is difficult because of the multiple challenges associated with rural and under-resourced areas. These challenges include accessibility of health-care facilities, shortage of experienced rehabilitation professionals and limited rehabilitation models to direct how the rehabilitation of CWDs should be conducted within a rural South African context. The primary research question for this study was: how should a model for the rehabilitation of CWDs look like in Giyani? The aim of the study was to develop a descriptive model for the rehabilitation of CWDs by health-care workers. The objectives of the study were to: (1) synthesise concepts, (2) synthesise non-relational statements, (3) organise relational statements, and (4) present the theory as a model with an ultimate goal of improving the health, function, and participation of CWDs. A qualitative, theory-generating, exploratory, descriptive and contextual approach was used. Data collection was divided into two phases. The primary objective of Phase 1 was to generate data through face-to-face interviews with caregivers of CWDs, rehabilitation professionals and community rehabilitation workers (CRWs) in order to develop concepts. The objective of Phase 2 was to expand data gathering from caregivers and rehabilitation professionals through focus group discussions (FGDs). Data from the interviews and FGDs was transcribed verbatim, translated into English, and analysed using an inductive approach. Ten caregivers participated in the interviews. Participants were predominantly mothers and unemployed. The CWDs whose caregivers participated in the interviews were under the age of six and had mostly a cerebral palsy diagnosis (80%). Eight rehabilitation professionals and two CRWs participated in the interviews. A total of ten caregivers participated in three FGDs. Participants were predominantly mothers. The CWDs whose caregivers participated in FGDs were less than or equal to two years of age and were diagnosed with cerebral palsy (80%). Six rehabilitation professionals participated in one FGD. Sixteen concepts and non-relational statements were developed: 1) cause of childhood disability 2) available services 3) role of caregivers 4) caregivers‘ source of support 5) caregivers‘ coping strategy 6) caregivers‘ level of satisfaction 7) caregivers‘ expectations 8) role of rehabilitation professionals 9) rehabilitation professionals‘ competency 10) factors that affect the rehabilitation professionals‘ work ethic 11) rehabilitation professionals‘ plan of action 12) role of CRWs 13) role of the municipality towards people with disabilities 14) role of Pfunanani Special School 15) challenges experienced 16) societal perception of CWDs Seven relational statements were developed to show the relationship between the sixteen concepts. Lastly, a model for the rehabilitation of CWDs was presented. The implication of the model is that the rehabilitation professionals and CRWs have a responsibility to reduce child-related, family-caregiver related, and health-care related challenges. In addition, the local government and the education sector have a responsibility to reduce community related challenges. The assumption of the model is that a reduction in child-related, family-caregiver related, health-care related, and community related challenges is likely to improve the caregivers‘ ability to support the CWD and ensure that there is continuity of care or treatment.