Research

1. Inclusive public health systems: Continuity of care for persons with disabilities (Tess Padayachee, PhD in Disability Studies: PhD Project in process.
2. Repositioning SLP practices: Engaging with family and community narratives to evolve communication supports for neurodivergent children (Prianka Parusnath, PhD Speech-language Pathology): Project in Process
   Acknowledgement: Prianka presented the project at the IALP conference, in NZ in August 2023 and was acknowledged as the presentation which moved the conference the most.
3. Generating competencies for disability inclusion in the medical curriculum Dr Sarah Whitehead, PhD in Health Sciences Education graduated in Dec 2022. https://www.news.uct.ac.za/article/-2023-07-14-phd-proposal-shows-how-disability-can-be-included-in-mbchb-training.
4. Curriculum change for optometrists for public health service delivery (Prasidh Ramson, PhD in Health Sciences Education) PhD in Process.
5. Access to and utilisation of antenatal care services by women with physical disabilities in rural south-Western Uganda (Ponsiano Kabakyenga Nuwagaba, PhD in Disability Studies, graduated July 2023)
6. A case study exploring occupational perspective social inclusion of social inclusion among young adults dually affected by substance use disorder and HIV/AIDS (Dr Clement Nhunzvi, Completed PhD)
7. Inclusive education and health: Experience of first-time cochlear implant users in Zimbabwe (Tinashe Primrose Nkhokwara, PhD Audiology) Project in Process
8. Speech-language therapy services in special needs schools in Eastern Cape (Nomvuyo Ncgobo, Masters in Speech-language Pathology- Project in Process
9. An exploration of recovery among South African men with a severe mental  illness (Fadia Gamieldien, PhD in Public Mental Health, project in Process
10. Disability Inclusive Workforce Development to Strengthen Health Systems

Prof Lorenzo (PI) received the Faculty of Health Sciences’ Research Stimulus grant of R250 000 for 2023, to explore the Health system strengthening through disability-inclusive workforce development, which will focus on alumni of the Higher Certificate in Disability Practice and how they are implementing disability inclusion in the community-oriented primary care framework.   

Disability Inclusive Health Research Roundtable: Forthcoming

The Development of a network map of organisations in disability and health sector is in development.  The forthcoming focus on inclusive health stream will focus on inclusive health in research. Details to follow.

Exploring continuity of care concepts in relation to people-centered care and the needs of persons with disabilities living with non-communicable diseases in South Africa: by Dr Tess Padayachee

1.1 Background

Healthcare systems worldwide are increasingly working to improve patient outcomes by recognising the important role of approaches that prioritize holistic care tailored to individuals and communities. Living with non-communicable diseases in most circumstances requires careful long term care. Persons with Disabilities diagnosed with non-communicable diseases have additional needs which must be understood to ensure that their treatment regimens are accessible and appropriately managed. Good continuity of care is often associated with the delivery of services using person and people centered approaches which are vital to this population as many rely on family and community support structures, particularly in low-resource settings. Within an African context, people centered care and continuity of care, demand deeper exploration and adaptation. These concepts are important for achieving equitable, sustainable, and culturally sensitive healthcare that aligns with African values, traditions, and challenges.

This postdoctoral  study, by recent doctorate graduate Tess Padayachee, builds on the findings of her PhD entitled “A case study of factors influencing primary healthcare “Continuity of Care” for Persons with Disabilities”. One of the key findings of the study was the need to better understand concepts of “Continuity of Care”, person centered care and people centered care within an African context. This study is premised on the fact that person and people-centered care support better continuity of care and to maximise its potential use in South African health policies, both need to be understood and used appropriately. A limited analysis of primary healthcare policies showed that concepts of continuity of care were not used consistently between policies. Furthermore, many of the terms used were adopted from northern hemisphere countries and there was a need for the concept to be understood within an African context where factors that drive care continuity extend beyond the health facility and with a stronger emphasis on community driven models of care that respect the role and influence of traditional health practitioners and cultural practices and leverage off strong community leadership.

Findings of the PhD study also indicated that concepts like people and person centered care are often used interchangeably in policy and practice despite having distinctly different definitions. Given that many primary health care policies are to be updated in the next few years, this study aims to contribute to a South African understanding of these concepts for the overall benefit of improved continuity of care and appropriate use in the future design and delivery of primary healthcare services.

This desktop study will map out how key concepts of continuity of care are used in primary healthcare policies in terms of their consistency and intent. Furthermore, how these concepts relate to an African context will be  described critically with reference to the needs of Persons with Disabilities. The study will present a summary the components necessary for inclusive health policies, with specific relevance Persons with Disabilities with chronic conditions.

1.2 Research Question

How are the concepts of continuity of care and associated terms such as people-centered care defined in primary health policies in South Africa with reference to the needs of Persons with Disabilities?

1.3 Research Objectives

1. To examine South African primary healthcare policies to establish terms used to describe continuity of care and examine their coherence and consistent use across primary healthcare policies.
2. To identify gaps and limitations in how continuity of care is defined with reference to the needs of needs and priorities of Persons with Disabilities.
3. To develop recommendations for policy makers for the design of inclusive people centered health policies that work to address the specific needs of Person with Disabilities with non-communicable diseases.

2. Methodology

This desktop study will assess all South African primary healthcare policies (going beyond the 6 analysed in the PhD study) to analyse concepts related to continuity of care and people centered care in terms of coherence, consistency and sensitivity to the needs of persons with disabilities.  The policy analysis will include three levels of analysis:

Level 1: The modified EquiFrame Framework will be used to analyse policies with an additional layer of analysis that provides insight into patterns of its use across polices.  . 

Level 2: Mapping of terminology related to continuity of care and person centered care

Level 3: Analysis of patterns in the use concepts across policies. 

3. Research outputs

• A concise report on the key findings and a policy brief with recommendations for policy makers within the National Department of Health.
• Two publications from PhD study

1. Deaf learners’ experiences of access to Higher Education in Lesotho (Bongiwe Buzi, Disability Studies, Masters). Bongiwe Buzi is a student who identifies as Deaf.
2. How the medical programme can become disability inclusive (Lefa Kekana, Disability Studies, Masters). Project in Progress
   Acknowledgement: Dr. Lefa Kekana was awarded the best student presentation at the World Disability and Rehabilitation Conference in Sri Lanka. Navigating the Clinical years: experiences of medical students with disabilities.
3. Barriers and facilitators experienced by youth with disabilities in transitioning from high school to university/higher education in South Africa, Ghana and Ethiopia. Led by International Centre for the Advancement of Community Based Rehabilitation at Queens University, Canada; in collaboration with University of Gondar, Ethiopia; Ashesi University, Ghana; and University of Cape Town, South Africa. Prof Theresa Lorenzo was PI for the SA site, and Sumaya Gabriels was -researcher and co-ordination, with two Mphil students with disabilities as co-researchers, Dureyah Abrahams and Ncikazi Nyoka.Completed.International symposia held in Cape Town, Addis Ababa and Accra from 25 Nov – 1 December 2022
4. Designing an innovative MSC in Occupational Therapy Curriculum with Cameroon Baptist Convention Health Services Prof Theresa Lorenzo and Emeritus Prof Madie Duncan, Disability Studies
5. Higher education opportunities for change: The case of disability inclusion in Mauritius (Sambala Chemen, PhD, Disability Studies PhD) Project in process.
6. Navigating participation in university life: Experiences of marginalised students in South Africa accessing student support (Leigh-Ann Richards, Masters, Occupational Therapy) Project in Process
7. Higher Education students’ experiences of belonging (Sidney Muchemwa, Occupational Therapy) Project in Process
8. Mental Health and Disability Inclusion Project: Student focus
   Prof Galvaan initiated a collaboration and visited Kings College London and Student Minds to explore different approaches to structuring student mental health research and possibilities for funding. This has created excellent opportunities for supporting existing student projects and a commitment to collaborating on future research.
   
   Prof Galvaan completed a short course on Introduction to Implementation Science offered by Kinds College. The course provided and overview and basic knowledge required to conduct implementation research or apply implementation theories and frameworks to their practice. It allowed opportunities for networking with experts and identifying possibilities for applying implementation science to mental health research.

1. Layla Kamedien: Study on LOFOB centre-based communication supports for blind and visually- impaired children. Master of Speech-language Pathology, study completed 2023.
2. Nomvuyo Ngcobo: Study of communication needs of intellectually impaired/neurodiverse children in rural Eastern Cape.  Masters in Speech-language pathology. Study in process.
3. Saskia Hadskins: Teacher experiences of communication support in Grade R classrooms in the Western Cape: A Case study. Study proposal in process
4.  Unati Stemela: Career Construction and the support of D/deaf high school learners in Eastern Cape. PhD completed.
5. How children with disabilities in the Western Cape experience participating in a surf therapy programme (Roxy Davis, PhD in Disability Studies) study in process.

Project stream Convenor: Prof Kathard

Advocacy for inclusion of Sign Language in national conversation on multilingualism: Prof Kathard participated in a national conversation held by UCT and advocated for sign language to be considered as a national language.  Sign language is now included as a national language in SA.

Early childhood communication supports:  The NRF study on Early childhood communication development concludes in 2023. The outcomes of the study will form implementation strategies. A symposium in being planned jointly with representatives from Communication Science professions from all sectors in SA to identify the resources available for early language literacy development and to plan a national Speech-language Therapy strategy to advance early inclusive childhood communication development. Further details to follow.

 The EPIC project link: https://health.uct.ac.za/epic/epic-practices

Prof Galvaan is leading the interprofessional curriculum change process in Department of Health and Rehabilitation Department. Furthermore, she is advocating for an inclusive mental health strategy.

Prof Kathard led the implementation of the Faculty and Interfaculty curriculum change projects at UCT in 2022/2023 in her capacity as acting DVC Teaching and Learning.

Prof Lorenzo continues to work with Disability Services, UCT to strengthen disability support systems. Furthermore, the Disability Studies team continues to strengthen disability inclusion in undergraduate health professions education.

Project Stream Convenor: Dr. Adele Ebrahim

This stream of research focuses on the opportunities for creating inclusive employment and for making the corporate, NGO and Government sectors disability inclusive.

1. Livelihood development in the informal sector: The experience of women with vision impairments in Ghana (Elizabeth Ladjer Bibi Agbettor, PhD in Disability Studies, completed)
2. Disability Employment Support Services: A case study of formal employment for Persons with Disabilities in South Africa (Karina Fischer-Mogensen, PhD in Disability Studies, completed)
3. Traversing Disability in South Africa: Considering Social Capital in Disability Inclusive Employment Practices (Adele Ebrahim, PhD in Disability Studies, completed)

Inclusive Practice Africa’s workplace programme
Creating an inclusive workplace where individuals with disabilities feel valued, respected, and empowered is not only a legal and ethical imperative but also a necessary step towards fostering a diverse and thriving work environment. By embracing workplace inclusion for people with disabilities, organizations can harness a wealth of unique perspectives, talents, and capabilities that contribute to innovation, productivity, and overall success—it is a strategic investment in building a more resilient, compassionate, and sustainable future for all.
Download more information