Thesis (MMed)--Stellenbosch University, 2005. / ENGLISH ABSTRACT:The decentralisation of health care services in the primary health care
system poses a challenge to the delivery of care to the communities in
Zambia. Little is being done in the Ministry of Health to incorporate
community-based rehabilitation (CBR) in the mainstream of primary health
care service delivery despite rehabilitation being regarded as the fourth
component of primary health care.
According to statistics, there are 256 690 (2.7%) persons with disabilities in
Zambia, of which 38.8% are persons with physical disabilities. There are
various community-based rehabilitation programmes in the country trying to
meet the needs of persons with disabilities but these programmes have not
been evaluated to determine the impact which CBR has on the lives of
persons with disabilities. This study aimed to determine the impact of a
community-based rehabilitation intervention strategy on persons with
physical disabilities in an urban and rural setting in Zambia. It is hoped that
the results of this study can be utilised as a means to lobby the Zambian
government to become involved in the rehabilitation process.
An experimental study was done using a community-based rehabilitation
intervention strategy on 66 persons with physical disabilities, of which 62%
were male and 38% female, from Lusaka urban and Chipata rural
community-based rehabilitation programmes. The researcher completed a
self-compiled questionnaire during a personal interview with the
participants/proxy. The questionnaire comprised demographic data and an
assessment of the disability status of persons with physical disabilities
regarding movement, functional activities and their integration into the
community. Perceptions of persons with physical disabilities or their proxy as
regards their disability status and experiences were also assessed by means
of two open-ended questions in the questionnaire.
The community-based rehabilitation intervention strategy was conducted for
six (6) months by the community rehabilitation workers who visited
participants once a week. Data was analysed both quantitatively and
qualitatively to determine the impact of a community-based rehabilitation
intervention strategy and to test the null hypothesis.
The results of this study showed that in Lusaka on one hand, persons with
physical disabilities had improvements in movement, functional activities and
integration level. On the other hand, Chipata showed that persons with
physical disabilities had improvements only regarding integration into the
community. However, combined scores showed that community-based
rehabilitation had an impact on persons with physical disabilities regarding
movement, functional activities and integration into the community. The study
also showed that there was a correlation between integration and movement,
and integration and functional activities. There was no correlation between
integration and caregiver provision and dependency, whereas there was a
negative correlation between perceptions and integration.
Based on these findings, it is recommended that the Ministry of Health takes
up the responsibility of spearheading and coordinating community-based
rehabilitation programmes and incorporating the activities in the existing
structures of primary health care. / AFRIKAANSE OPSOMMING:Die desentralisasie van gesondheidsorgdienste in die primere
gesondheidstelsel hou 'n uitdaging vir dienslewering aan gemeenskappe in
Zambie in. Die Ministerie van Gesondheid doen nie veel om
gemeenskapsgebaseerde rehabilitasie (GBR) by die hoofstroom van primere
gesondheidsorg dienslewering in te Iyf nie, ten spyte daarvan dat
rehabilitasie as die vierde komponent van primere gesondheidsorg beskou
word.
Daar word beraam dat daar 256 690 (2.7%) mense met gestremdhede in
Zambie is, waarvan 38.8% mense met liggaamlike gestremdhede is. Daar is
verskeie gemeenskapsgebaseerde rehabilitasieprogramme in die land wat
poog om in die behoeftes van mense met gestremdhede te voorsien, maar
hierdie programme is nie geevalueer om die impak van GBR op die lewens
van mense met gestremdhede te bepaal nie. Hierdie studie het ten doel
gehad om die impak van 'n gemeenskapsgebaseerde rehabilitasieintervensiestrategie
vir mense met liggaamlike gestremdhede in 'n stedelike
en landelike omgewing in Zambie te bepaal. Daar word gehoop dat die
resultate van hierdie studie gebruik kan word om druk op die Zambiese
regering uit te oefen om by die rehabilitasieproses betrokke te raak.
'n Eksperimentele studie is gedoen deur 'n gemeenskapsgebaseerde
rehabilitasie-intervensiestrategie op 66 mense met liggaamlike
gestremdhede van die Lusaka stedelike en Chipata landelike
gemeenskapsgebaseerde rehabilitasieprogramme toe te pas. Twee en sestig
persent (62%) van die respondente was manlik en 38% vroulik. Die navorser
het tydens 'n persoonlike onderhoud met deelnemers of hulle
gevolmagtigdes 'n selfopgestelde vraelys voltooi. Die vraelys het uit
demografiese data en 'n bepaling van die mense se gestremdheidstatus ten
opsigte van beweging, funksionele aktiwiteite en hulle integrasie in die
gemeenskap bestaan. Persepsies van mense met liggaamlike gestremdhede
of hulle gevolmagtigdes rakende hulle gestremdheidstatus en ervarings is
ook deur middel van twee oop vrae in die vraelys bepaal.Die gemeenskapsgebaseerde rehabilitasie-intervensiestrategie is vir ses (6)
maande toegepas deur gemeenskapsrehabilitasiewerkers wat die
deelnemers een maal 'n week besoek het. Data is sowel kwantitatief as
kwalitatief ontleed om die impak van 'n gemeenskapsgebaseerde
rehabilitasie-intervensiestrategie te bepaal en die nulhipotese te toets.
Die resultate van die studie het aangedui dat mense met liggaamlike
gestremdhede in Lusaka verbetering ten opsigte van beweging, funksionele
aktiwiteite en vlak van integrasie getoon het. Mense met liggaamlike
gestremdhede in Chipata, daarteenoor, het slegs ten opsigte van integrasie
in die gemeenskap verbetering getoon. Gekombineerde tellings het egter
getoon dat gemeenskapsgebaseerde rehabilitasie ten opsigte van beweging,
funksionele aktiwiteite en integrasie in die samelewing 'n impak op mense
met liggaamlike gestremdhede gehad het. Die studie het ook getoon dat daar
'n korrelasie tussen integrasie en beweging, en integrasie en funksionele
aktiwiteite bestaan. Daar was geen korrelasie tussen integrasie en
versorgervoorsiening en -afhanklikheid nie, en daar was 'n negatiewe
korrelasie tussen persepsies en integrasie.
Op grand van hierdie bevindinge word aanbeveel dat die Ministerie van
Gesondheid verantwoordelikheid vir die leiding en koordinasie van
gemeenskapsgebaseerde rehabilitasieprogramme aanvaar en hierdie
aktiwiteite by die aktiwiteite van bestaande primere gesondheidsorgstrukture
inlyf.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:sun/oai:scholar.sun.ac.za:10019.1/70115 |
| Date | 04 1900 |
| Creators | Banda-Chalwe, M. |
| Contributors | Mji, M. G., Stellenbosch University. Faculty of Medicine and Health Science . Dept. of Interdisciplanry Health Sciences . Centre for Rehabilitation Studies. |
| Publisher | Stellenbosch : Stellenbosch University |
| Source Sets | South African National ETD Portal |
| Language | en_ZA |
| Detected Language | Unknown |
| Type | Thesis |
| Format | 265 p. : ill. |
| Rights | Stellenbosch University |
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