The journal is published for the purpose of advancing scholarship in disability studies and rehabilitation sciences in a uniquely African context. Widely read by scholars, professionals and students, it encourages scholarly exchange between all disciplines and academics from low, middle and high-income countries to work towards the improvement of human development and its practices across the continent.

Background: The effective implementation of disability and rehabilitation frameworks is essential for the full participation and social integration of individuals with disabilities. In Gauteng, South Africa, significant challenges persist in the execution of the Framework and Strategy for Disability and Rehabilitation (FSDR). This study aimed to explore the barriers and facilitators to the implementation of the FSDR in Gauteng.Methods: We employed qualitative research methods, including semi‐structured interviews and focus group discussions with stakeholders involved in the implementation process, from management to end users. Data were triangulated with a review of paper‐based implementation reports from rehabilitation managers. The interview, focus group, and document review data were analyzed using inductive thematic analysis with MAXQDA qualitative data analysis software.Results: Barriers to implementation included resource constraints, organizational inefficiencies, and socio‐cultural attitudes toward disability. Facilitators identified included inter‐sectoral collaboration, community engagement, and alignment of policies with international guidelines. Using the Consolidated Framework for Implementation Research (CFIR), barriers and facilitators were mapped to domains such as intervention characteristics, outer and inner setting factors, characteristics of individuals, and the implementation process. Key challenges included insufficient awareness and training among healthcare professionals, limited resources, safety concerns, and inconsistent policy implementation. Facilitators such as inter‐sectoral collaboration, policy development, provincial training, and advocacy by persons with disabilities were crucial for overcoming these challenges.Conclusion: This study provides valuable insights into the contextual factors influencing disability and rehabilitation policy implementation in Gauteng. By addressing identified barriers and leveraging facilitators, evidence‐based strategies can strengthen rehabilitation services, promote social inclusion, and enhance the rights of individuals with disabilities in South Africa and globally.

Background: The Framework and Strategy for Disability and Rehabilitation (FSDR) in South Africa aims to improve rehabilitation services for individuals with disabilities. However, research related to its implementation process is limited. Aim: To explore the experiences of the implementation process of FSDR among stakeholders in Gauteng, South Africa. Setting: The study was conducted in 5 districts in the Gauteng Province of South Africa namely, City of Johannesburg, Ekurhuleni, West Rand, Sedibeng, and Tshwane. Methods: A descriptive qualitative study design was used, combining semi-structured interviews and focus groups with diverse stakeholders, including clinicians, rehabilitation managers and community health workers. Data were analysed thematically using MAXQDA software, with key themes mapped deductively to the stages of the EPIS (Exploration, Preparation, Implementation, Sustainment) framework to identify key implementation steps taken. Results: Challenges to implementation including resource shortages, limited career progression, weak management communication and procedural inefficiencies were reported. Participants emphasised the need for policy adaptations reflecting field experiences and advocated for increased accountability and resources. The EPIS framework highlighted the critical role of phase-specific interventions and continuous monitoring for effective policy implementation. Conclusion: The study concludes that systemic barriers must be addressed to enhance the sustainability and impact of the FSDR policy on rehabilitation services. Contribution: Recommendations include fostering accountability, improving resource allocation and realigning policies with frontline needs to ensure long-term improvements in disability and rehabilitation services.

Background: The prevalence of disability is increasing. The rights of persons with disabilities have not been upheld and health policy is a tool to actualise these rights. The Framework and Strategy for Disability and Rehabilitation (FSDR) for South Africa (2015-2022) has expired but the implementation process has not been evaluated to inform future disability policy implementation.Objectives: To evaluate the perceptions of the implementation of the FSDR to develop implementation strategies.Method: An explanatory mixed methods study comprising of a document review, semi-structured interviews and focus group discussions with stakeholders involved in the implementation process of the FSDR in Gauteng province, will be employed. The document review and interview transcript analysis will utilise initially inductive thematic analysis (Alhojailen), followed by deductive analysis using established implementation science frameworks. Data will be triangulated from semi-structured interviews and focus group discussions to develop implementation strategies for future disability policy.Clinical implications: This study will contribute to the field of policy analysis, as well as improving the implementation of future disability policy in South Africa to protect the rights of persons with disabilities. The study findings may also be used as a tool for advocacy to improve rehabilitation service provision in South Africa.International Journal of Human and Health Sciences Vol. 07 No. 04 Oct’23 Page: 277-285

Background: The global estimate of shoulder pain is 67% and is often associated with subacromial impingement syndrome. Interventions include corticosteroid injection (CSI) therapy and physiotherapy. Further information is needed to compare the effect of these interventions on pain, joint range of motion (ROM) and shoulder function. Objectives: To summarise the best evidence comparing the effect of CSI versus physiotherapy on pain, shoulder ROM and shoulder function in patients with subacromial impingement syndrome. Method: This evidence statement is based on a systematic review and meta-analysis of three randomised controlled trials (RCTs), namely, Rhon et al. (2014) (n = 136), Hay et al. (2003) (n = 207) and Van der Windt et al. (1998) (n = 109), with a total of 452 participants. A total of 14 studies were reviewed and only 3 studies met the inclusion criteria. Results: An improvement in shoulder function was found in favour of CSI at 6- to 7-week follow-up (p < 0.0001), but no evidence was found for the superiority of CSI compared to physiotherapy for pain and ROM over 4–12 weeks. In 24 and 48 weeks, no evidence was found for the superiority of CSI compared to physiotherapy for shoulder function, pain or ROM. Conclusion: No evidence was found for the superiority of CSI compared to physiotherapy for pain and ROM in the short term besides an improvement in shoulder function in favour of CSI at 6–7 weeks. There was a weak recommendation with moderate quality of evidence based on three RCTs (2B). Clinical implications: This evidence statement may inform clinical practice when determining which intervention is best suited to manage patients with shoulder pain.

Background: The prevalence of disability is on the rise globally and in South Africa, with a high number of unmet needs and poor actualisation of the health rights of persons with disabilities. A tool to realise these rights is health policy, such as the framework and strategy for disability and rehabilitation (2015-2022)(FSDR). There are limited data on the implementation outcomes of the FSDR. Objective: To review the implementation of the FSDR according to the paper-based provincial reports. Methods: The study conducted a document review and utilised a concurrent mixed-method design, combining qualitative and quantitative data extracted from paper-based evaluation templates developed by the South African National Department of Health (NDoH). The qualitative analysis involved thematic coding using the RE-AIM framework to examine the FSDR’s implementation across eight provinces, while quantitative data, such as frequencies and percentages, provided supplementary insights. Results: The quantitative results revealed that 87% of the reports from provinces reported physical accessibility to the FSDR, and 62% of provinces received training on the implementation of the FSDR. Only two out of eight provinces have conducted monitoring and evaluation since implementing the FSDR in 2015. Qualitative findings revealed poor reach and adoption of the FSDR owing to a lack of implementation training for end users. The lack of indicators resulted in poor maintenance of the FSDR, as well as the lack of human resources and equipment which resulted in the reduced efficacy of the FSDR. Conclusion: The FSDR has not achieved its full level of implementation due to numerous barriers, such as lack of resources, human capacity, and training on implementation.