Provision of rehabilitation services within the District Health System - the experience of rehabilitation managers in facilitating this right for people with disabilities*

The South African government has embarked on widescale policy reforms in the provision of essential health and rehabilitation services, especially for vulnerable groups of society. The District Health System was promulgated to improve the efficiency and effectiveness of the health system by transferring authority over decision-making at a more local level. These reforms have resulted in the need to restructure, reorganise and reorientate service providers towards a rights-based approach in the delivery of these services. Primary research, using a qualitative case study method to explore the challenges in implementing policy changes within a rights-based framework, was conducted at a selected urban district in South Africa. Findings show that there were several factors that impeded the capacity to deliver rehabilitation services within the new policy framework at the district level. These factors have constrained successful policy implementation intended to guide rehabilitation services within the public health sector, resulting in the rights-based approach to service delivery being compromised.