Browsing by Author "Mpanza, December Mandlenkosi."

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An integrated model of aftercare for substance use disorder clients in KwaZulu-Natal.
(2023) Mpanza, December Mandlenkosi.; Govender, Pragashnie.; Voce, Anna Silvia.
Background: There is currently a high global burden of substance use, which is burdensome to the public health and welfare system. Adequate treatment, including aftercare services, tends to be limited worldwide. In South Africa (SA), substance abuse contributes considerably to morbidity and mortality and treatment services are not only limited but also fragmented among stakeholders. These problems are compounded by a number of factors, including the absence of aftercare policies, treatment models, a lack of resources, and an absence of norms and standards for aftercare services. Consequently, most persons with Substance Use Disorders (SUDs) do not receive aftercare. Furthermore, there is high relapse and many re-admissions of persons with SUDs, which exacerbates the burden on the health care and welfare systems. The situation appears to be worse in rural districts. South African policies have called for the development of an aftercare model of care for persons with SUDs, which has not been realised to date. Aim: The aim of the study was to propose an integrated model of aftercare for persons with SU post-inpatient treatment phase in a public facility in KwaZulu-Natal. Methodology: A qualitative study in two phases. The first phase: policy analysis, and the second phase had two stages: Stage one was semi-structured and focus group interviews with forty-six participants who represented all five levels of the Beer’s Viable System Model (VSM) from governmental and non-governmental organisations (NGOs). Stage two semi-structured interviews with five persons with SUDs and their family members (n=5). Data was analysed thematically using the Braun and Clarke approach. Results: Findings indicated that South African policies did not provide clear guidelines on aftercare. Aftercare was found to be lacking, fragmented, poorly coordinated among service providers and not well integrated into the substance use treatment system. The needs of service users demonstrated the extent and nature of aftercare required. Conclusion: The extent and nature of aftercare services warranted aftercare services that are integrated into SUD treatment systems, lifelong orientated, and responsive to the needs of persons with SUDs and their families. An integrated recovery management model of care is proposed together with relapse management strategies.
Substance abuse and rural realities : experiences and perceptions of service providers in northern KwaZulu-Natal, South Africa.
(2014) Mpanza, December Mandlenkosi.; Naidoo, Pragashnie.
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