Background: South Africa’s quadruple burden of disease, coupled with health system challenges and other factors, predicts a high burden of disability within the population. Human Resources for Health policy and planning need to take account of this challenge. Occupational therapists are part of the health rehabilitation team, and their supply and status in the workforce need to be better understood. Methods: The study was a retrospective record-based review of the Health Professions Council of South Africa database from 2002 to 2018. The data obtained from the Health Professions Council of South Africa was analysed for the following variables: geographical location, population groups, age, practice type and sex. Data was entered on a Microsoft Excel spreadsheet and analysed using the Statistical Package for the Social Sciences (SPSS version 22.0). Results: In 2018, there were 5180 occupational therapists registered with the Health Professions Council of South Africa with a ratio of 0.9 occupational therapists per 10 000 population. There has been an average annual increase of 7.1% over the time period of 2002–2018. The majority of occupational therapists are located in the more densely populated and urbanised provinces, namely Gauteng, Western Cape and KwaZulu-Natal. Most of the registered occupational therapists are under the age of 40 years (67.7%). The majority (66%) are classified as white followed by those classified as black and coloured. Females make up 95% of the registered occupational therapists. Nationally, 74.8% of occupational therapists are deployed in the private sector catering for 16% of the population while approximately 25.2% are employed in the public sector catering for 84% of the population. Conclusions: Under-resourcing and disparities in the profile and distribution of occupational therapy human resources remain an abiding concern which negatively impacts on rehabilitation service provision and equitable health and rehabilitation outcomes.

Background: Twenty-two years after the promulgation of a plethora of progressive health policies since 1994, the South African public health system reflects a number of stumbling blocks regarding implementation. Rehabilitation professionals are not sufficiently equipped nor allowed the opportunity to comprehensively implement Primary Healthcare (PHC) from a bottom-up approach, thus engaging communities. Training on addressing social health determinants and their impact on ill-health and health outcomes is inadequate. The inadequate understanding of the advocacy role that rehabilitation professionals could play in addressing social health determinants remains a challenge in healthcare. Rehabilitation, a pillar of PHC, remains poorly understood in terms of its role within the health system.Aim: We argue for rehabilitation as a vehicle for addressing social determinants of health with community service practitioners playing a critical role in addressing the inequities within the healthcare package.Setting: The article reflects the opportunities and challenges faced by rehabilitation community service therapists in the delivery of rehabilitation services in a rural area of the Eastern Cape province of South Africa.Methods: A single case study from the perspective of a researcher was used to explore the experience and reflection of the first author during her community service as an occupational therapist.Results: The case study highlights some existing gaps within the delivery of rehabilitation services in the rural Eastern Cape. A community service package with a specific approach towards addressing social determinants of health for persons with disability at a community level is suggested.Conclusion: Advocating for a rehabilitation service package to shift to community-based levels is critical. It is envisaged that a community-based approach will facilitate an understanding of the barriers faced by persons with disabilities as constituting disability, thus facilitating learning about the disabling consequences of the rural environment coupled with the system as experienced by persons with disabilities.

Disability studies globally is concerned, in various ways, with questions of systemic injustices and inequities that persons with disabilities are subjected to. Persons with disabilities are often positioned as the objects of research rather than equal thinkers and knowledge bearers in their own right. These issues are amplified in the context of African societies, where access is even more challenging than in wealthier countries, and many persons with disabilities are excluded from education altogether. This situation reinforces their epistemic vulnerability. As such, there is limited work on doing disability research from the frame of reference of those in these African societies. This article operates at the nexus of two scholarly traditions. The first of these is the field of disability studies, which is generally dominated by Global North thinking than ideas and experiences from the Global South, and which has addressed questions of knowledge and participation quite extensively, but most commonly in high-income countries. The second is the long-standing political and epistemological African Renaissance lens for understanding and rebelling against imperialism and neo-colonial advances in formerly colonized African societies. I integrate and engage these two scholarly traditions to contribute to charting possibilities of what critical disability studies might look like and mean, from the premise of an African Renaissance. Central to this discussion is building on African theorization while also challenging the dominating and hegemonic white-centric theorization that dominates the field and epistemology in general.

Background: The capacity of service providers in the public sector to deliver inclusive services is essential to implement strategies that will allow the full participation of disabled youth in development opportunities in the rural context. Objective: The article sets to describe the capacity of service providers in facilitating participation of disabled youth in economic development opportunities. Method: An instrumental, embedded single case study informed the research design. The sample consisted of five disabled youth, four family members as well as six service providers. Data was gathered through in-depth individual interviews and focus group discussions. Data analysis was done inductively and thematically. In the discussion, the interpretation used organisational capacity elements as a framework. Findings: The theme on service providers indicates their understanding of disability as still a multifaceted and a challenging issue with different orientations to service delivery based on understanding of impairment and disability. There is a dominant focus on impairment and negative attitudes. Discussion: An asset building approach could facilitate awareness of capacities of disabled youth and thus shift negative attitudes to an enabling attitude. The vague strategies for youth and women that are described as inclusive are a misrepresentation of the reality of experiences of disabled youth. Conclusion: An appreciative process of facilitating a holistic understanding of the needs of disabled people is needed to assist service providers to reconceptualise disability within an expansive framework.

In 2018, the United Nations global report showed that people with disabilities, who make up 15% of the worlds' population, have poorer health and rehabilitation access (SDG 3). Without improving the needed person-centered health and rehabilitation services at household level, SDG 3 cannot be achieved. This includes addressing human resource shortages through training multi-skilled community based rehabilitation workers (CRWs) to build rural workforce capacity and enhance the lives of people with disabilities, particularly in LMICs where the need is higher but resources are lower. However, to date, there is no documentation and analysis of existing training and its scope for this workforce in LMICs. A situational mapping overview was undertaken to review the current status of rural rehabilitation training programs offered in Southern Africa for CRWs. CRWs are rehabilitation personnel, based in the home/community, who are not professionals (without a bachelor qualification) but render non-institutional rehabilitation and inclusive development in communities, under the supervision of rehabilitation practitioners. Information on these programs was obtained using a two-step process. Firstly, a descriptive list of university courses for rehabilitation workers offered in the Southern African countries was collected via an internet and literature search. Secondly, detailed information about the disability and rural rehabilitation courses was collected from the respective institutions and their designated websites. There are six training courses targeted at CRWs or disability practitioners with a disability focus being offered at universities in Southern Africa, five of these in South Africa and one in Zimbabwe. Additionally, four training courses are offered as online/open resources by global organizations and are self-directed with no accreditation. While other key competencies feature, none of these programmes' learning outcomes make direct reference to the rural practice context and its complexities in relation to disability and poverty. The situational mapping overview shows limited training targeted at CRWs in Southern Africa, to effectively facilitate rural rehabilitation, poverty reduction and social inclusion. There is a need for an articulated community-orientated rural training to respond to the unmet needs. This may require a different set of competencies and assessment standards for trainees as well as additional competencies for their supervisors and mentors.

In 2020, the African Network of Evidence to Action on Disability (also known as AFRINEAD) hosted its 10th conference in Cape Town. This paper synthesises inputs by the three authors as plenary addresses, particularly focusing on the challenges and opportunities of centring African voices in disability research. Our concern in this article is to engage with the question of exclusion as an issue not just in the everyday lives of people with disabilities but also in the world of ideas – the ideational space. We suggest that a reimagined disability study depends on the centring of African experiences, voices and knowledges. This is especially so as there are African concepts that are not rigorously pursued in research. African Renaissance thinking makes allowance not only for critically reflecting on the historical and contemporary constructs of disability but also for fashioning a higher civilisation in which people with disabilities can exist within society as worthy and valued human beings.