Abstract
This paper describes a situation analysis of the rehabilitation personnel, employed by the state and non-governmental organisations, and the services available for people with disabilities in one health district in Cape Town. The recurrent cost of employing the rehabilitation personnel is analysed to determine how funding is allocated within the district. The results indicate that most expenditure on personnel is at two state institutions in the district, with 76% of the expenditure at the regional psychiatric hospital and its residential facility for people with a profound intellectual disability. The balance - 24% of expenditure - is the cost of employing rehabilitation personnel who provide a district level service. Seventy percent of this district level expenditure is at one special school that accepts 6% of children with disabilities in the district. A high percentage of intellectually disabled children and adults, with or without physical disabilities, do not have access to rehabilitation. There is minimal expenditure on employing rehabilitation personnel at the community heath centre. The only expenditure on community based rehabilitation is provided by the non-governmental organisation. The study demonstrates the inequitable distribution of funding for rehabilitation services within one relatively well-resourced health district and makes recommendations to facilitate change.
Highlights
In any country the state has a responsi bility to ensure equity in the provision o f health services, including rehabilitation
Analysis of the cost of rehabilitation can make an im portant contribution to planning health care services (WHO 1994). It gives an indication of the proportion o f the total budget that is spent on rehabilitation services, where this spending takes place in the district, and who has access to the service
Cost of rehabilitation personnel Regional and district level rehabilitation services Seventy six percent (76%) of the total expenditure on employing rehabilitation personnel was at the regional psychiatric hospital, Lentegeur Hospital, including the Care and Rehabilitation Centre for profoundly intellectually disabled people
Summary
In any country the state has a responsi bility to ensure equity in the provision o f health services, including rehabilitation. This study explores an aspect o f equity in one health district in Cape Town It describes a situation analysis of the rehabilitation personnel and the facilities available for people with disabilities. Analysis of the cost of rehabilitation can make an im portant contribution to planning health care services (WHO 1994). It gives an indication of the proportion o f the total budget that is spent on rehabilitation services, where this spending takes place in the district, and who has access to the service. It enables planners to consider alternative uses of available funding They may, for example, choose to use a greater or lesser proportion for a com m unity based rehabilitation service
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