Substance abuse and rural realities : experiences and perceptions of service providers in northern KwaZulu-Natal, South Africa.
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Date
2014
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Abstract
Substance abuse is recognized as a worldwide problem and in South Africa contributes to
significant morbidity and mortality. However, there appears to be concerns in the service delivery especially
in rural areas. This is partly due to the minimal South African research that has overlooked the impact of
indigenous substances which have affected many, notably those in rural areas and disadvantaged
communities. Therefore a qualitative phenomenological study with substance abuse service providers in
UMkhanyakude Rural District of KwaZulu Natal, South Africa was conducted. Methods: Focus groups and
interviews were conducted with various stakeholders, namely Mental Health Care Teams within hospitals,
managers at a District Health Level, social workers and managers from Department of Social Development
and fieldworkers and manager of the NGO-Ophondweni Youth Development Initiative in UMkhanyakude
District. Results: The findings of the study suggests that service providers experience challenges in service
delivery in rural areas of South Africa. These include, culture (amarula festival and ancestral worship) that
exacerbates the use of substances, high rate of unemployment and poverty such that people resort to home
brewed substances for sustainable living, lack of resources within the respective work places (NGOs and
governmental departments) of service providers (staff shortage and equipment/vehicles). The lack of
resources is also exacerbated by the geographical isolation of rural areas, consequently, the treatment or
rehabilitation is weak and disjointed among stakeholders. Furthermore poor monitoring and evaluation of
services coupled with lack of research in rural areas was noted. Strengths included prevention programmes,
good inter-sectoral collaboration including strong support from civil societies. Conclusion: The collective
perceptions and experiences of rural substance abuse service providers were challenging in rendering the
service in rural areas. However, there were strengths or enablers noted. Evidently, the South African acts
and policies has overlooked rural areas and a lack of resources exacerbates the situation. It is
recommended that protocol and service standard for Substance Abuse Occupational Therapy services for
after care and community based rehabilitation should be developed for easier monitoring and evaluation
for quality improvement rehabilitation services
Description
Master of Occupational Therapy. University of KwaZulu-Natal, Westville 2014.
Keywords
Drug abuse--South Africa--KwaZulu-Natal., Rural health services--South Africa--KwaZulu-Natal., Addicts--Services for--South Africa--KwaZulu-Natal., Theses--Occupational therapy., Substance abuse.