Perceived readiness of South African community service speech–language therapists to manage complex paediatric dysphagia

Abstract

Background: Feeding and swallowing difficulties usually demand specialised knowledge and skills for effective assessment and management. In South Africa, community service speech–language therapists (SLTs) play an integral role in delivering care within the public healthcare system, where the ratio of patients to medical professionals is notably disproportionate. However, the extent to which they feel prepared when managing these conditions remains relatively underexplored.
Objectives: To explore the extent to which community service SLTs feel prepared when managing paediatric feeding and swallowing difficulties, the challenges they experience, and the resources and support systems available to them.
Method: An explorative descriptive qualitative design was used in this study. Data were collected using online surveys and analysed using inductive thematic analysis. Twelve clinicians participated in this study, all of whom worked in different public healthcare institutions throughout South Africa.
Results: Three themes emerged: (1) lack of confidence and self-doubt in their clinical skills; (2) systemic factors within the public health sector that impede service delivery; and (3) difficulty in navigating caregiver health beliefs and the duty of care.
Conclusion: This study provides a nuanced understanding of the lack of preparedness community service SLTs feel when managing children with complex feeding and swallowing difficulties. The findings further underscore the need for additional mentorship support for these therapists, especially in facilities where there are no established speech therapy services.
Contribution: The study has implications for improved service delivery initiatives and curriculum reform at institutions of higher learning.