Visagie Surona, Scheffler Elsje, Schneider Marguerite
Centre for Rehabilitation Studies, Stellenbosch University, South Africa.
DARE Consult, Stellenbosch, South Africa.
Afr J Disabil. 2013 Sep 9;2(1):63. doi: 10.4102/ajod.v2i1.63. eCollection 2013.
Wheelchairs allow users to realise basic human rights and improved quality of life. South African and international documents guide rehabilitation service delivery and thus the provision of wheelchairs. Evidence indicates that rehabilitation policy implementation gaps exist in rural South Africa.
The aim of this article was to explore the extent to which wheelchair service delivery in a rural, remote area of South Africa was aligned with the South African National Guidelines on Provision of Assistive Devices, The United Nations Convention on the Rights of Persons with Disabilities and The World Health Organization Guidelines on Provision of Wheelchairs in Less-Resourced Settings.
Qualitative methods were used. Data were collected through semi-structured interviews with 22 participants who were identified through purposive sampling. Content analysis of data was preformed around the construct of wheelchair service delivery.
Study findings identified gaps between the guiding documents and wheelchair service delivery. Areas where gaps were identified included service aspects such as referral, assessment, prescription, user and provider training, follow up, maintenance and repair as well as management aspects such as staff support, budget and monitoring. Positive findings related to individual assessments, enthusiastic and caring staff and the provision of wheelchairs at no cost.
The gaps in policy implementation can have a negative impact on users and the service provider. Inappropriate or no wheelchairs limit user function, participation and quality of life. In addition, an inappropriate wheelchair will have a shorter lifespan, requiring frequent repairs and replacements with cost implications for the service provider.
轮椅能让使用者实现基本人权并提高生活质量。南非及国际文件为康复服务的提供，进而为轮椅的供应提供了指导。有证据表明，南非农村地区在康复政策实施方面存在差距。
本文旨在探讨南非一个偏远农村地区的轮椅服务提供在多大程度上符合《南非辅助器具供应国家指南》、《联合国残疾人权利公约》以及《世界卫生组织资源匮乏地区轮椅供应指南》。
采用定性研究方法。通过对22名通过目的抽样确定的参与者进行半结构化访谈收集数据。围绕轮椅服务提供的架构对数据进行内容分析。
研究结果发现了指导文件与轮椅服务提供之间的差距。发现存在差距的领域包括转诊、评估、处方、用户和提供者培训、随访、维护和修理等服务方面，以及工作人员支持、预算和监测等管理方面。积极的发现涉及个别评估、热情且有爱心的工作人员以及免费提供轮椅。
政策实施中的差距可能会对用户和服务提供者产生负面影响。不合适的轮椅或没有轮椅会限制用户的功能、参与度和生活质量。此外，不合适的轮椅使用寿命较短，需要频繁维修和更换，这会给服务提供者带来成本问题。
