A chasm: Consequences of poor collaboration between health and education in paediatric cerebral palsy care in Johannesburg

Abstract

Background: Nearly 20 years since the establishment of the National Rehabilitation Policy, strides have been made within the health and education sectors to improve accessibility to rehabilitation services as well as the quality of life of children with cerebral palsy (CP). Shortfalls, however, still exist in implementing the policy. An in-depth study into the implementation of policy would be beneficial in identifying and understanding the shortfalls of the rehabilitation process.

Objectives: To investigate the perceptions of Speech-Language Therapists (SLTs) working in the Gauteng Department of Health (GDH) and Gauteng Department of Education (GDE), in Johannesburg Region A, about systemic strengths and weaknesses surrounding the service delivery for children with CP, from birth to 6 years.

Method: A qualitative study was conducted. Thirty-one (31) SLTs working in public hospitals, clinics and schools for Learners with Special Educational Needs participated in eight focus group interviews. Interviews were audio-recorded for transcription and subsequent thematic analysis.

Results: The participants reported a lack of resources and knowledge that contributed to a perceived chasm between the GDH and GDE, resulting in fragmented and uncoordinated service delivery for children with CP leaving the health system and entering the education system.

Conclusion: The results suggest that a cohesive plan should be formulated to bridge the perceived chasm between GDH and GDE in the referral process of children with CP from the health setting, into the school environment. This may facilitate communication, collaboration, education, as well as resource-sharing between the departments. Rehabilitation professionals should actively participate in such planning processes.