A survey of occupational therapists' involvement in facilitating self-employment for people with disabilities

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Background: Literature indicates that access to rehabilitation services in South Africa is limited. Recent policy documents by the National Department of Health related to disability and rehabilitation propose the integration of occupational therapy services in primary healthcare (PHC). However, the implementation strategies concerning integration are not clear as there is inadequate evidence locally on the occupational therapy service provision in PHC even though there is growing evidence internationally.Purpose: This study sought to determine the services provided by occupational therapists in PHC and to explore the perceptions of the occupational therapists on the integration of occupational therapy services within the PHC reengineering streams of the National Health Insurance (NHI).Method: A two-phase explanatory sequential mixed method strategy was utilised in this study. A quantitative survey was sent to members of the occupational therapy professional association and an organisation of professionals providing rehabilitation services in rural communities. Qualitative data were then collected using semi-structured interviews with five therapists who completed the survey.Findings: Findings from this study showed there is increasing alignment of occupational therapy services in PHC with the communitybased rehabilitation (CBR), the Social Model, the International Classification of Functioning, Disability and Health (ICF), and the Medical Model using client self-management and case-management intervention approaches. The majority of occupational therapists are currently based in district hospitals (42%), community health centres (16%), community organisations (8%), and clinics (8%). Those working in the community indicated they work in a multidisciplinary team (MDT). They also use PHC service delivery models to manage people with disabilities (PWDs). Occupational therapists in PHC have a strong perception of their relevance in the PHC reengineering streams, despite the numerous barriers and few facilitators to the integration of occupational therapy services in the PHC reengineering streams of the NHI.Conclusion: The perception of the study participants is that occupational therapy service integration in the PHC reengineering streams will lead to improved healthcare. However, they are also of the opinion that integration will not happen without advocacy from occupational therapists or occupational therapy being adequately supported in PHC.✥ Anthony Jejelaye -Postgraduate student -conceptualisation and completion of project and article manuscript. ✥ Lebogang Maseko -supervisor of MSc project -helped with the conceptualisation and guidance for completion of project. ✥ Denise Franzsen -supervisor of MSc project -helped with the conceptualisation and guidance for completion of project.

Section: Discussionmentioning

confidence: 93%

Occupational therapy services and perception of integration of these at primary healthcare level in South Africa

Jejelaye¹,

Maseko²,

Franzsen³

2019

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“…Most businesses were in the retail and service and skills sector (Table II, p77). The type of microenterprises were service and skill, retail and manufacturing/production businesses 13 such as a privately owned pre-school crèche, a spaza shop and a salon operating from a one-roomed brick house.…”

Section: Methodsmentioning

confidence: 99%

“…Occupational therapists have a well-defined role in facilitating clients' engagement in the occupation of work 8 . This role takes into account both the assessment of both the clients' work abil-ISSN On-line 2310-3833 Creative Commons License 4.0 ity and work place when providing vocational rehabilitation and includes preparing a client for seeking, procuring and/or sustaining employment 9 . Both local and global literature shows that the vocational rehabilitation services currently offered by occupational therapists focus mainly on paid employment, with little research and focus on facilitating self-employment or entrepreneurship as a work placement opportunity for their clients 10,11 .…”

Section: Introduction and Literature Reviewmentioning

confidence: 99%

“…Occupational therapy vocational rehabilitation services are currently not in line with the South African government's call for citizens to explore self-employment as an alternative in the face of the high level of unemployment and its effects 12 . Although South African occupational therapists perceive themselves as having a role to play in facilitating self-employment for PWDs, they report a lack of experience in fulfilling this role 13 .…”

Section: Introduction and Literature Reviewmentioning

confidence: 99%

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The application of the Vona du Toit Model of Creative Ability to self-employment in South African informal microenterprises

Monareng

Franzsen

Casteleijn

et al. 2021

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INTRODUCTION: Persons with disabilities experience difficulties entering the formal South African labour market despite progressive legislation to enhance their economic participation. Consequently, self-employment becomes a work placement consideration for occupational therapy clients. However, self-employment requires certain volitional attributes, and the identification of such attributes would greatly enhance the outcome of vocational rehabilitation efforts. The aim of the study was to describe the level of creative ability of self-employed business owners in informal microenterprises METHOD: A descriptive, quantitative non-experimental research design was used. Sixteen self-employed business owners of informal microenterprises were interviewed and observed completing work tasks using the eight domains of the Activity Participation Outcome Measure (ApOM) based on the Vona du Toit Model of Creative Ability (VdTMoCA RESULTS: Participants were between 27 and 50 years of age. Their education levels ranged from no-education (6%) to tertiary education (19%) with the majority (38%) having a high school education. Based on the APOM scores, participants functioned on three levels of creative ability namely: Passive Participation, Imitative Participation and Active Participation. Most participants functioned at the Imitative patient-directed level with the highest APOM domain scores for all participants being Communication Skills, Affect and Role Performance CONCLUSION: To be successfully self-employed in an informal microenterprise, the required level of creative ability ranging from Passive to Active Participation, was identified. This provides occupational therapists with an understanding of these requirements when considering self-employment as work placement option Key words: Self-employment, informal, microenterprise, Vona du Toit Model of Creative Ability (VdTMoCA), Activity Participation Outcome Measure (APOM), work, vocational rehabilitation, placement.

“…For example, several authors describe how, in assessment, occupational therapists often rely on informal methods (e.g., observation, interview) or adapt formal measures because most standardised tools are developed in Western countries 34,35 . In terms of interventions, the prevalence of poverty and limited employment opportunities for people with disabilities in various African contexts behoves occupational therapists to focus on vocational skills [36][37][38] , facilitating self-employment 39 and other options for income generation 30,31,40 .…”

Section: Occupational Therapists' Activities: Empowering People To Engage In Meaningful Occupationmentioning

confidence: 99%

The role of Occupational Therapy in Africa: A scoping review

Vuuren¹,

Okyere²,

Aldersey³

2021

Objective: This scoping review explores the role of occupational therapy in African countries including major practice areas, specific activities within practice areas, and potential considerations unique to the African context. Method: Two authors independently reviewed articles from online database searches and manual searches of reference lists and specific Occupational Therapy journals using a combination of keywords related to 'Occupational Therapy', 'Africa', and 'role'. Articles were included based on pre-determined eligibility criteria (i.e., peer-reviewed, English articles that describe occupational therapists' tasks/ activities) and discussion to reach consensus. The authors charted data through content analysis of the articles based on the review's objectives prior to drawing out common themes relevant to the African context. Results: Thirty-two articles were included covering twelve African countries, though predominantly focused on South Africa. Findings demonstrate that, despite having tasks specific to practice areas, the overarching role of occupational therapy is facilitating engagement in meaningful occupation. Additionally, the findings highlight a vital role for African therapists in community-based services and the need to consider the unique cultural context in practice. Conclusion: Congruent with universal occupational therapy principles, Occupational Therapy in Africa aims to facilitate engagement in meaningful occupation, but therapists should consider their unique cultural context to ensure meaningful and sustainable outcomes whilst maintaining a valuable universal identity.