Developing policy-informed principles for rehabilitation using a model of care framework: a hand therapy example in a Global South context

Contextually responsive rehabilitation necessitates services being shaped by policy. This imperative extends to the field of hand therapy, given a substantial and increasing burden of hand injuries in South Africa. To inform a strategic response to this need, this study sought to develop policy-based principles for hand therapy services delivered by occupational therapists in South Africa.A qualitative document synthesis was undertaken. Relevant local and international policies (n=29) were identified by a review of the literature, stakeholder consultation and expert review. Ritchie and Spencer’s (1994) framework analysis was employed.Eighteen generic rehabilitation principles were generated under three categories: the goal of rehabilitation (full participation and inclusion); the nature of rehabilitation (quality patient-centred care; equity and equality; accessible services; truly comprehensive care; an occupational focus; work interventions); and enablers of rehabilitation (intersectoral action for vital communities; empowered clients and communities; a vital workforce; resources including assistive devices and technology; infrastructure and equipment; seamless services; leadership and governance; financing; data for service improvement; networks and partnerships; responsive and anticipatory).The generic nature of the principles allows versatile application of these policy principles to numerous fields of rehabilitation practice. Specific application of the principles is discussed for hand therapy services in South Africa