Abstract:
Improving developmental outcomes for children and
youth with disabilities (CYWD) in low- and middleincome countries requires the removal of access barriers
perpetuating the patterns of exclusion of persons with
disabilities in general. In South Africa, an upper middleincome country with stark characteristics of inequality,
intervention and support are hampered by inadequate
coordination, and confusion regarding roles and
responsibilities between key stakeholders in the health and
education sectors. The World Disability Report highlights
poor coordination of services, inadequate staffing, and
poor staff competencies as critical in determining the
quality, accessibility, and adequacy of services for persons
with disabilities. The South African National Departments
of Health and Basic Education both have individual as
well as coordinated policies that should facilitate the
participation of CYWD in environments important to their
health, development and academic abilities. However, there
is a disjuncture in how these policies are implemented at
provincial, district, hospital, and school level when children
transition between these sectors.
Drawing on bioecological systems theory, the chapter
explores how intersectoral collaboration in the health
and education sectors is affected by poor coordination
and integration at various levels of the system for
CYWD. The chapter further proposes how rehabilitation
professionals working in these two sectors and delivering
intervention services at grassroots level, can start to use
a biopsychosocial approach, such as the International
Classification for Functioning, Disability and Health, to
transform their practices and improve coordination of roles
and responsibilities. This would allow CYWD to transition
more seamlessly between these sectors, mitigating
the systemic barriers that lead to inadequate health,
development and academic outcomes for disabled children.
