Implementation of the framework for disability and rehabilitation in Gauteng, South Africa

Abstract

Background: The Framework and Strategy for Disability and Rehabilitation (FSDR) in South Africa aims to improve rehabilitation services for individuals with disabilities. However, research related to its implementation process is limited.
Aim: To explore the experiences of the implementation process of FSDR among stakeholders in Gauteng, South Africa.
Setting: The study was conducted in 5 districts in the Gauteng Province of South Africa namely, City of Johannesburg, Ekurhuleni, West Rand, Sedibeng, and Tshwane.
Methods: A descriptive qualitative study design was used, combining semi-structured interviews and focus groups with diverse stakeholders, including clinicians, rehabilitation managers and community health workers. Data were analysed thematically using MAXQDA software, with key themes mapped deductively to the stages of the EPIS (Exploration, Preparation, Implementation, Sustainment) framework to identify key implementation steps taken.
Results: Challenges to implementation including resource shortages, limited career progression, weak management communication and procedural inefficiencies were reported. Participants emphasised the need for policy adaptations reflecting field experiences and advocated for increased accountability and resources. The EPIS framework highlighted the critical role of phase-specific interventions and continuous monitoring for effective policy implementation.
Conclusion: The study concludes that systemic barriers must be addressed to enhance the sustainability and impact of the FSDR policy on rehabilitation services.
Contribution: Recommendations include fostering accountability, improving resource allocation and realigning policies with frontline needs to ensure long-term improvements in disability and rehabilitation services.