# Reconfiguring Rehabilitation Services for Rural South Africans with Disabilities During a Health Emergency: A Qualitative Descriptive Study

## TL;DR

This study explores how orthotic and prosthetic services in rural South Africa were disrupted and adapted during the COVID-19 pandemic.

## Contribution

The study provides insights into how rehabilitation services can be reconfigured to remain inclusive during health emergencies.

## Key findings

- Service delivery was hindered by halted outreach clinics and limited access to materials.
- Adaptations included implementing safety measures and managing backlogs.
- Lingering challenges highlight the need for disability-inclusive emergency policies.

## Abstract

The COVID-19 pandemic and the subsequent hard lockdown in South Africa, implemented in March 2020, significantly disrupted disability and rehabilitation services. Persons with disabilities experienced limited access to essential Orthotic and Prosthetic services, particularly in rural provinces such as the Eastern Cape. This study aimed to explore how Medical Orthotists and Prosthetists reconfigured their services during and after the pandemic to inform disability-inclusive emergency responses. A descriptive qualitative study was conducted with 12 Medical Orthotists and Prosthetists practicing in the public sector in the Eastern Cape. Semi-structured interviews were conducted via MS Teams, and the data were analysed by using thematic analysis to identify key themes related to service disruptions and adaptations. Four main themes emerged: (1) disrupted access to Orthotic and Prosthetic services, (2) backlogs and limited services, (3) safety measures and adaptation control, and (4) lingering challenges and gaps. Service delivery was hindered by halted outreach clinics, limited access to materials, budget reallocations, and the deprioritisation of rehabilitation services. This study highlights the challenges faced by Medical Orthotists and Prosthetists in maintaining the functionality of Orthotic and Prosthetic services during the pandemic. These findings emphasise the need for disability-inclusive policies and strategies to ensure the continuity of rehabilitation services during emergencies.