{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T16:26:03Z","timestamp":1785428763815,"version":"3.56.0"},"reference-count":74,"publisher":"AOSIS","issue":"0","license":[{"start":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T00:00:00Z","timestamp":1765497600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Background:\u00a0People with neurological conditions resulting in disabilities face a multitude of challenges in their journey of care. Existing evidence recommends exploring region-specific care pathways to understand the multi-faceted factors that influence the health outcomes of people with neurological conditions.\nObjectives:\u00a0To explore the care pathway for neurological conditions in a specialised rehabilitation hospital in Gauteng, South Africa.\nMethod:\u00a0This study used an explorative qualitative design. Semi-structured interviews were conducted with a purposeful sample of patients with neurological conditions and health professionals. All interviews were transcribed verbatim, and a framework analysis was used for data processing and interpretation.\nResults:\u00a0Two overarching themes emerged: the lack of an integrated care pathway and the key role players along the care pathway. Components in the care pathway continuum included the onset and emergency management, admission into an acute facility, waiting for admission into the rehabilitation hospital, inpatient and outpatient specialised rehabilitation care and community care. Participants described role players in the care pathway.\nConclusion:\u00a0This study describes a detailed care pathway for people with neurological conditions in the healthcare system. Evidence suggests the lack of an integrated pathway for people with neurological conditions, especially in acute and community care settings. Multiple key components and role players are recommended for an integrated care pathway.\nContribution:\u00a0There is a need to develop an integrated care pathway for neurological conditions to minimise clinical risk and improve patient outcomes.<\/jats:p>","DOI":"10.4102\/ajod.v14i0.1726","type":"journal-article","created":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T08:10:44Z","timestamp":1765440644000},"update-policy":"https:\/\/doi.org\/10.4102\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Exploring the care pathway for neurological conditions in a Gauteng rehabilitation hospital, South Africa"],"prefix":"10.4102","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-0086-112X","authenticated-orcid":false,"given":"Prisha","family":"Alakram-Khelawon","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03rp50x72","id-type":"ROR","asserted-by":"publisher"}],"name":"University of the Witwatersrand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0606-9669","authenticated-orcid":false,"given":"Sonti","family":"Pilusa","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03rp50x72","id-type":"ROR","asserted-by":"publisher"}],"name":"University of the Witwatersrand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8017-6708","authenticated-orcid":false,"given":"Natalie","family":"Benjamin-Damons","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03rp50x72","id-type":"ROR","asserted-by":"publisher"}],"name":"University of the Witwatersrand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2580","published-online":{"date-parts":[[2025,12,12]]},"reference":[{"key":"ref0","doi-asserted-by":"crossref","unstructured":"Ahmed, N., Quadir, M.M., Rahman, M.A. & Alamgir, H., 2018, \u2018Community integration and life satisfaction among individuals with spinal cord injury living in the community after receiving institutional care in Bangladesh\u2019, Disability and Rehabilitation 40(9), 1033\u20131040. https:\/\/doi.org\/10.1080\/09638288.2017.1283713","DOI":"10.1080\/09638288.2017.1283713"},{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Aubert, I., Kletz, F. & Sardas, J.-C., 2023, \u2018The patient as an actor in his care pathway: Insights from the French case\u2019, Health Services Insights 16, 11786329231196028. https:\/\/doi.org\/10.1177\/11786329231196029","DOI":"10.1177\/11786329231196029"},{"key":"ref2","doi-asserted-by":"crossref","unstructured":"Badhiwala, J.H., Wilson, J.R., Harrop, J.S., Vaccaro, A.R., Aarabi, B., Geisler, F.H. et al., 2022, \u2018Early vs late surgical decompression for central cord syndrome\u2019, JAMA Surgery 157(11), 1024. https:\/\/doi.org\/10.1001\/jamasurg.2022.4454","DOI":"10.1001\/jamasurg.2022.4454"},{"key":"ref3","doi-asserted-by":"crossref","unstructured":"Battistuzzo, C.R., Armstrong, A., Clark, J., Worley, L., Sharwood, L., Lin, P. et al., 2016, \u2018Early decompression following cervical spinal cord injury: Examining the process of care from accident scene to surgery\u2019, Journal of Neurotrauma 33(12), 1161\u20131169. https:\/\/doi.org\/10.1089\/neu.2015.4207","DOI":"10.1089\/neu.2015.4207"},{"key":"ref4","doi-asserted-by":"crossref","unstructured":"Becker, I., Maleka, M.D., Stewart, A., Jenkins, M. & Hale, L., 2022, \u2018Community reintegration post-stroke in New Zealand: Understanding the experiences of stroke survivors in the lower South Island\u2019, Disability and Rehabilitation 44(12), 2815\u20132822. https:\/\/doi.org\/10.1080\/09638288.2020.1839792","DOI":"10.1080\/09638288.2020.1839792"},{"key":"ref5","doi-asserted-by":"crossref","unstructured":"Bharatan, T., Devi, R., Huang, P.H., Javed, A., Jeffers, B., Lansberg, P. et al., 2021, \u2018A methodology for mapping the patient journey for noncommunicable diseases in low-and middle-income countries\u2019, Journal of Healthcare Leadership 13, 35\u201346. https:\/\/doi.org\/10.2147\/JHL.S288966","DOI":"10.2147\/JHL.S288966"},{"key":"ref6","doi-asserted-by":"crossref","unstructured":"Bradshaw, D., Nannan, N.N., Pillay-van Wyk, V., Laubscher, R., Groenewald, P. & Dorrington, R.E., 2019, \u2018Burden of disease in South Africa: Protracted transitions driven by social pathologies\u2019, South African Medical Journal 109(11b), 69\u201376. https:\/\/doi.org\/10.7196\/SAMJ.2019.v109i11b.14273","DOI":"10.7196\/SAMJ.2019.v109i11b.14273"},{"key":"ref7","doi-asserted-by":"crossref","unstructured":"Brazeau, H. & Davis, C.G., 2018, \u2018Hope and psychological health and well-being following spinal cord injury\u2019, Rehabilitation Psychology 63(2), 258\u2013266. https:\/\/doi.org\/10.1037\/rep0000209","DOI":"10.1037\/rep0000209"},{"key":"ref8","doi-asserted-by":"crossref","unstructured":"Cameron, J.I., 2021, \u2018Family caregiving research: Reflecting on the past to inform the future\u2019, Journal of Spinal Cord Medicine 44(suppl 1), S19\u2013S22. https:\/\/doi.org\/10.1080\/10790268.2021.1970883","DOI":"10.1080\/10790268.2021.1970883"},{"key":"ref9","doi-asserted-by":"crossref","unstructured":"Cao, Y., DiPiro, N. & Krause, J.S., 2020, \u2018Association of secondary health conditions with future chronic health conditions among persons with traumatic spinal cord injury\u2019, Topics in Spinal Cord Injury Rehabilitation 26(4), 283\u2013289. https:\/\/doi.org\/10.46292\/sci20-00020","DOI":"10.46292\/sci20-00020"},{"key":"ref10","doi-asserted-by":"crossref","unstructured":"Cao, Y., Li, C., Newman, S., Lucas, J., Charlifue, S. & Krause, J.S., 2017, \u2018Posttraumatic stress disorder after spinal cord injury\u2019, Rehabilitation Psychology 62(2), 178\u2013185. https:\/\/doi.org\/10.1037\/rep0000135","DOI":"10.1037\/rep0000135"},{"key":"ref11","doi-asserted-by":"crossref","unstructured":"Crawford, L., Maxwell, J., Colquhoun, H., Kingsnorth, S., Fehlings, D., Zarshenas, S. et al., 2022, \u2018Facilitators and barriers to patient-centred goal setting in rehabilitation: A scoping review\u2019, Clinical Rehabilitation 36(12), 1694\u20131704. https:\/\/doi.org\/10.1177\/02692155221121006","DOI":"10.1177\/02692155221121006"},{"key":"ref12","unstructured":"Department of Health (South Africa), 2012, National health act, regulations relating to categories of hospitals (Government Notice R.185, Government Gazette No. 35101), Government Gazette, Pretoria."},{"key":"ref13","doi-asserted-by":"crossref","unstructured":"Ding, C., Wu, Y., Chen, X., Chen, Y., Wu, Z., Lin, Z. et al., 2022, \u2018Global, regional, and national burden and attributable risk factors of neurological disorders: The global burden of disease study 1990\u20132019\u2019, Frontiers in Public Health 10, 952161. https:\/\/doi.org\/10.3389\/fpubh.2022.952161","DOI":"10.3389\/fpubh.2022.952161"},{"key":"ref14","doi-asserted-by":"crossref","unstructured":"Dorstyn, D.S., Chur-Hansen, A., Mansell, E., Murphy, G., Roberts, R.M., Stewart, P. et al., 2023, \u2018Facilitators and barriers to employment for persons with chronic spinal cord injury or disorder: A qualitative study framed by the person-environment-occupation model\u2019, Journal of Spinal Cord Medicine 46(2), 246\u2013255. https:\/\/doi.org\/10.1080\/10790268.2021.1922231","DOI":"10.1080\/10790268.2021.1922231"},{"key":"ref15","doi-asserted-by":"crossref","unstructured":"Duan, R., Qu, M., Yuan, Y., Lin, M., Liu, T., Huang, W. et al., 2021, \u2018Clinical benefit of rehabilitation training in spinal cord injury\u2019, Spine 46(6), E398\u2013E410. https:\/\/doi.org\/10.1097\/BRS.0000000000003789","DOI":"10.1097\/BRS.0000000000003789"},{"key":"ref16","doi-asserted-by":"crossref","unstructured":"Feigin, V.L., Vos, T., Nichols, E., Owolabi, M.O., Carroll, W.M., Dichgans, M. et al., 2020, \u2018The global burden of neurological disorders: Translating evidence into policy\u2019, Lancet Neurology 19(3), 255\u2013265. https:\/\/doi.org\/10.1016\/S1474-4422(19)30411-9","DOI":"10.1016\/S1474-4422(19)30411-9"},{"key":"ref17","doi-asserted-by":"crossref","unstructured":"Fern\u00e1ndez-M\u00e9ndez, R., Wong, M.Y., Rastall, R.J., Rebollo-D\u00edaz, S., Oberg, I., Price, S.J. et al., 2020, \u2018Improvement of the efficiency and completeness of neuro-oncology Patient referrals to a tertiary center through the implementation of an electronic referral system: Retrospective cohort study\u2019, Journal of Medical Internet Research 22(3), e15002. https:\/\/doi.org\/10.2196\/15002","DOI":"10.2196\/15002"},{"key":"ref18","doi-asserted-by":"crossref","unstructured":"Ferrari, A.J., Santomauro, D.F., Aali, A., Abate, Y.H., Abbafati, C., Abbastabar, H. et al., 2024, \u2018Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990\u20132021: A systematic analysis for the global burden of disease study 2021\u2019, Lancet 403(10440), 2133\u20132161. https:\/\/doi.org\/10.1016\/S0140-6736(24)00757-8","DOI":"10.1016\/S0140-6736(24)00757-8"},{"key":"ref19","doi-asserted-by":"crossref","unstructured":"Flach, C., Muruet, W., Wolfe, C.D.A., Bhalla, A. & Douiri, A., 2020, \u2018Risk and secondary prevention of stroke recurrence\u2019, Stroke 51(8), 2435\u20132444. https:\/\/doi.org\/10.1161\/STROKEAHA.120.028992","DOI":"10.1161\/STROKEAHA.120.028992"},{"key":"ref20","doi-asserted-by":"crossref","unstructured":"Forero, R., Nahidi, S., De Costa, J., Mohsin, M., Fitzgerald, G., Gibson, N. et al., 2018, \u2018Application of four-dimension criteria to assess rigour of qualitative research in emergency medicine\u2019, BMC Health Services Research 18, 120. https:\/\/doi.org\/10.1186\/s12913-018-2915-2","DOI":"10.1186\/s12913-018-2915-2"},{"key":"ref21","doi-asserted-by":"crossref","unstructured":"Galloway, K.M. & Parker, R., 2018, \u2018Could an increase in vigilance for spinal tuberculosis at primary health care level, enable earlier diagnosis at district level in a tuberculosis endemic country?\u2019 African Journal of Primary Health Care & Family Medicine 10(1), a1666. https:\/\/doi.org\/10.4102\/phcfm.v10i1.1666","DOI":"10.4102\/phcfm.v10i1.1666"},{"key":"ref22","doi-asserted-by":"crossref","unstructured":"Gartner, J.-B., Abasse, K.S., Bergeron, F., Landa, P., Lemaire, C. & C\u00f4t\u00e9, A., 2022, \u2018Definition and conceptualization of the patient-centered care pathway, a proposed integrative framework for consensus: A concept analysis and systematic review\u2019, BMC Health Services Research 22, 558. https:\/\/doi.org\/10.1186\/s12913-022-07960-0","DOI":"10.1186\/s12913-022-07960-0"},{"key":"ref23","doi-asserted-by":"crossref","unstructured":"GBD 2021 Nervous System Disorders Collaborators, 2024, \u2018Global, regional, and national burden of disorders affecting the nervous system, 1990\u20132021: A systematic analysis for the global burden of disease study 2021\u2019, Lancet Neurology 23(4), 344\u2013381. https:\/\/doi.org\/10.1016\/S1474-4422(24)00038-3","DOI":"10.1016\/S1474-4422(24)00038-3"},{"key":"ref24","doi-asserted-by":"crossref","unstructured":"Gordon, T., Booysen, F. & Mbonigaba, J., 2020, \u2018Socio-economic inequalities in the multiple dimensions of access to healthcare: The case of South Africa\u2019, BMC Public Health 20, 289. https:\/\/doi.org\/10.1186\/s12889-020-8368-7","DOI":"10.1186\/s12889-020-8368-7"},{"key":"ref25","doi-asserted-by":"crossref","unstructured":"Govender, P., Naidoo, D., Bricknell, K., Ayob, Z., Message, H. & Njoko, S., 2019, \u201cNo one prepared me to go home\u201d: Cerebrovascular accident survivors\u2019 experiences of community reintegration in a peri-urban context\u2019, African Journal of Primary Health Care & Family Medicine 11(1), a1806. https:\/\/doi.org\/10.4102\/phcfm.v11i1.1806","DOI":"10.4102\/phcfm.v11i1.1806"},{"key":"ref26","doi-asserted-by":"crossref","unstructured":"Govender, V., Fried, J., Birch, S., Chimbindi, N. & Cleary, S., 2015, \u2018Disability grant: A precarious lifeline for HIV\/AIDS patients in South Africa\u2019, BMC Health Services Research 15, 227. https:\/\/doi.org\/10.1186\/s12913-015-0870-8","DOI":"10.1186\/s12913-015-0870-8"},{"key":"ref27","doi-asserted-by":"crossref","unstructured":"Grimmer, K., Louw, Q., Dizon, J.M., Van Niekerk, S.-M., Ernstzen, D. & Wiysonge, C., 2018, \u2018Standardising evidence strength grading for recommendations from multiple clinical practice guidelines: A South African case study\u2019, Implementation Science 13, 117. https:\/\/doi.org\/10.1186\/s13012-018-0803-0","DOI":"10.1186\/s13012-018-0803-0"},{"key":"ref28","doi-asserted-by":"crossref","unstructured":"Havana, T., Kuha, S., Laukka, E. & Kanste, O., 2023, \u2018Patients\u2019 experiences of patient-centred care in hospital setting: A systematic review of qualitative studies\u2019, Scandinavian Journal of Caring Sciences 37(4), 1001\u20131015. https:\/\/doi.org\/10.1111\/scs.13174","DOI":"10.1111\/scs.13174"},{"key":"ref29","doi-asserted-by":"crossref","unstructured":"Herzer, K.R., Chen, Y., Heinemann, A.W. & Gonz\u00e1lez-Fern\u00e1ndez, M., 2016, \u2018Association between time to rehabilitation and outcomes after traumatic spinal cord injury\u2019, Archives of Physical Medicine and Rehabilitation 97(10), 1620\u20131627.e4. https:\/\/doi.org\/10.1016\/j.apmr.2016.05.009","DOI":"10.1016\/j.apmr.2016.05.009"},{"key":"ref30","doi-asserted-by":"crossref","unstructured":"Huang, Y., Li, Y., Pan, H. & Han, L., 2023, \u2018Global, regional, and national burden of neurological disorders in 204 countries and territories worldwide\u2019, Journal of Global Health 13, 04160. https:\/\/doi.org\/10.7189\/jogh.13.04160","DOI":"10.7189\/jogh.13.04160"},{"key":"ref31","doi-asserted-by":"crossref","unstructured":"Khalil, H.M. & Lahoud, N., 2020, \u2018Knowledge of stroke warning signs, risk factors, and response to stroke among lebanese older adults in Beirut\u2019, Journal of Stroke and Cerebrovascular Diseases 29(5), 104716. https:\/\/doi.org\/10.1016\/j.jstrokecerebrovasdis.2020.104716","DOI":"10.1016\/j.jstrokecerebrovasdis.2020.104716"},{"key":"ref32","doi-asserted-by":"crossref","unstructured":"Kiger, M.E. & Varpio, L., 2020, \u2018Thematic analysis of qualitative data: AMEE Guide No. 131\u2019, Medical Teacher 42(8), 846\u2013854. https:\/\/doi.org\/10.1080\/0142159X.2020.1755030","DOI":"10.1080\/0142159X.2020.1755030"},{"key":"ref33","doi-asserted-by":"crossref","unstructured":"Kinoshita, S., Abo, M. & Okamoto, T., 2020, \u2018Effectiveness of ICF-based multidisciplinary rehabilitation approach with serial assessment and discussion using the ICF rehabilitation set in a convalescent rehabilitation ward\u2019, International Journal of Rehabilitation Research 43(3), 255\u2013260. https:\/\/doi.org\/10.1097\/MRR.0000000000000421","DOI":"10.1097\/MRR.0000000000000421"},{"key":"ref34","doi-asserted-by":"crossref","unstructured":"Langhammer, B., Sunnerhagen, K.S., Lundgren-Nilsson, \u00c5., S\u00e4llstr\u00f6m, S., Becker, F. & Stanghelle, J.K., 2017, \u2018Factors enhancing activities of daily living after stroke in specialized rehabilitation: An observational multicenter study within the Sunnaas International Network\u2019, European Journal of Physical and Rehabilitation Medicine 53(5), 725\u2013734. https:\/\/doi.org\/10.23736\/S1973-9087.17.04489-6","DOI":"10.23736\/S1973-9087.17.04489-6"},{"key":"ref35","doi-asserted-by":"crossref","unstructured":"Lee, M., Choi, Y., Lee, E.Y., Kim, D.-A. & Ho, S.H., 2020, \u2018Life experiences with using community care among people with severe physical disabilities: A comparative analysis between South Korea and Japan\u2019, International Journal of Environmental Research and Public Health 17(24), 9195. https:\/\/doi.org\/10.3390\/ijerph17249195","DOI":"10.3390\/ijerph17249195"},{"key":"ref36","doi-asserted-by":"crossref","unstructured":"Lekoubou, A., Nkoke, C., Dzudie, A. & Kengne, A.P., 2017, \u2018Recurrent stroke and early mortality in an urban medical unit in Cameroon\u2019, Journal of Stroke and Cerebrovascular Diseases 26(8), 1689\u20131694. https:\/\/doi.org\/10.1016\/j.jstrokecerebrovasdis.2017.03.031","DOI":"10.1016\/j.jstrokecerebrovasdis.2017.03.031"},{"key":"ref37","doi-asserted-by":"crossref","unstructured":"Linsler, S. & Reyes Medina, B., 2021, \u2018Neurosurgical treatment of cervical spine injuries\u2019, Der Radiologe 61, 720\u2013728. https:\/\/doi.org\/10.1007\/s00117-021-00881-9","DOI":"10.1007\/s00117-021-00881-9"},{"key":"ref38","doi-asserted-by":"crossref","unstructured":"Louw, Q.A., Conradie, T., Xuma-Soyizwapi, N., Davis-Ferguson, M., White, J., Stols, M. et al., 2023, \u2018Rehabilitation capacity in South Africa \u2013 A situational analysis\u2019, International Journal of Environmental Research and Public Health 20(4), 3579. https:\/\/doi.org\/10.3390\/ijerph20043579","DOI":"10.3390\/ijerph20043579"},{"key":"ref39","doi-asserted-by":"crossref","unstructured":"Lurie, T., Berman, E., Hassan, S., Jackson, M., Falcon, J., Najafali, D. et al., 2021, \u2018Early predictors of near-shore spinal injuries among emergency department patients\u2019, Journal of Emergency Medicine 60(1), 17\u201324. https:\/\/doi.org\/10.1016\/j.jemermed.2020.07.037","DOI":"10.1016\/j.jemermed.2020.07.037"},{"key":"ref40","doi-asserted-by":"crossref","unstructured":"Maart, R.A., Mji, G., Morris, L.D. & Ernstzen, D.V., 2024, \u2018The rehabilitation landscape in a low-to-middle-income country: Stakeholder perspectives and policy implications \u2013 A qualitative study\u2019, INQUIRY: The Journal of Health Care Organization, Provision, and Financing 61, 00469580241271973. https:\/\/doi.org\/10.1177\/00469580241271973","DOI":"10.1177\/00469580241271973"},{"key":"ref41","doi-asserted-by":"crossref","unstructured":"Maciel Barbosa, P., Firmino-Machado, J., Ferreira, L.N., Tedim Cruz, V. & Szrek, H., 2023, \u2018From healthcare system to individuals through stroke rehabilitation pathways. Outcomes, information, and satisfaction along 12 months prospective cohort in Portugal\u2019, Topics in Stroke Rehabilitation 30(7), 727\u2013737. https:\/\/doi.org\/10.1080\/10749357.2023.2165266","DOI":"10.1080\/10749357.2023.2165266"},{"key":"ref42","doi-asserted-by":"crossref","unstructured":"Madasa, V., Boggenpoel, B., Phillips, J. & Joseph, C., 2020, \u2018Mortality and secondary complications four years after traumatic spinal cord injury in Cape Town, South Africa\u2019, Spinal Cord Series and Cases 6, 84. https:\/\/doi.org\/10.1038\/s41394-020-00334-w","DOI":"10.1038\/s41394-020-00334-w"},{"key":"ref43","doi-asserted-by":"crossref","unstructured":"Magaqa, Q., Ariana, P. & Polack, S., 2021, \u2018Examining the availability and accessibility of rehabilitation services in a rural district of South Africa: A mixed-methods study\u2019, International Journal of Environmental Research and Public Health 18(9), 4692. https:\/\/doi.org\/10.3390\/ijerph18094692","DOI":"10.3390\/ijerph18094692"},{"key":"ref44","doi-asserted-by":"crossref","unstructured":"Magasi, S. & Papadimitriou, C., 2022, \u2018Peer support interventions in physical medicine and rehabilitation: A framework to advance the field\u2019, Archives of Physical Medicine and Rehabilitation 103(7), S222\u2013S229. https:\/\/doi.org\/10.1016\/j.apmr.2020.09.400","DOI":"10.1016\/j.apmr.2020.09.400"},{"key":"ref45","doi-asserted-by":"crossref","unstructured":"Maseko, L.J., Adams, F. & Myezwa, H., 2024, \u2018Perceptions of integrated rehabilitation service delivery in a metropolitan district\u2019, African Journal of Primary Health Care & Family Medicine 16(1), a4069. https:\/\/doi.org\/10.4102\/phcfm.v16i1.4069","DOI":"10.4102\/phcfm.v16i1.4069"},{"key":"ref46","doi-asserted-by":"crossref","unstructured":"Mashola, M.K., Olorunju, S.A.S. & Mothabeng, J., 2019, \u2018Factors related to hospital readmissions in people with spinal cord injury in South Africa\u2019, South African Medical Journal 109(2), 107. https:\/\/doi.org\/10.7196\/SAMJ.2019.v109i2.13344","DOI":"10.7196\/SAMJ.2019.v109i2.13344"},{"key":"ref47","doi-asserted-by":"crossref","unstructured":"Moran, K., Barclay, L. & Lannin, N.A., 2024, \u2018Experiences of people with non-traumatic spinal cord injuries returning home after inpatient rehabilitation\u2019, Disability and Rehabilitation 46(2), 362\u2013368. https:\/\/doi.org\/10.1080\/09638288.2022.2162611","DOI":"10.1080\/09638288.2022.2162611"},{"key":"ref48","doi-asserted-by":"crossref","unstructured":"Morris, L.D., Grimmer, K.A., Twizeyemariya, A., Coetzee, M., Leibbrandt, D.C. & Louw, Q.A., 2021, \u2018Health system challenges affecting rehabilitation services in South Africa\u2019, Disability and Rehabilitation 43(6), 877\u2013883. https:\/\/doi.org\/10.1080\/09638288.2019.1641851","DOI":"10.1080\/09638288.2019.1641851"},{"key":"ref49","doi-asserted-by":"crossref","unstructured":"Negrini, S., Selb, M., Kiekens, C., Todhunter-Brown, A., Arienti, C., Stucki, G. et al., 2022, \u2018Rehabilitation definition for research purposes. A global stakeholders\u2019 initiative by Cochrane rehabilitation\u2019, Neurorehabilitation and Neural Repair 36(7), 405\u2013414. https:\/\/doi.org\/10.1177\/15459683221093587","DOI":"10.1177\/15459683221093587"},{"key":"ref50","doi-asserted-by":"crossref","unstructured":"Nizeyimana, E., Joseph, C. & Phillips, J., 2022a, \u2018Quality of life after traumatic spinal cord injury in a developing context: The influence of contextual factors and injury characteristics\u2019, Disability and Rehabilitation 44(10), 2020\u20132026. https:\/\/doi.org\/10.1080\/09638288.2020.1827051","DOI":"10.1080\/09638288.2020.1827051"},{"key":"ref51","doi-asserted-by":"crossref","unstructured":"Nizeyimana, E., Joseph, C. & Phillips, J., 2022b, \u2018The role of self-efficacy in community reintegration among persons with traumatic spinal cord injury in South Africa\u2019, Journal of Spinal Cord Medicine 45(5), 739\u2013747. https:\/\/doi.org\/10.1080\/10790268.2020.1855867","DOI":"10.1080\/10790268.2020.1855867"},{"key":"ref52","doi-asserted-by":"crossref","unstructured":"Olaleye, O.A. & Agoro, Z.B., 2024, \u2018\u201cWe don\u2019t have to do it together\u201d: A qualitative study of physiotherapists and patients\u2019 perceptions about collaborative goal setting in Nigeria\u2019, Physiotherapy Theory Practice 40(4), 817\u2013827. https:\/\/doi.org\/10.1080\/09593985.2022.2152645","DOI":"10.1080\/09593985.2022.2152645"},{"key":"ref53","doi-asserted-by":"crossref","unstructured":"Otokita, S., Uematsu, H., Kunisawa, S., Sasaki, N., Fushimi, K. & Imanaka, Y., 2021, \u2018Impact of rehabilitation start time on functional outcomes after stroke\u2019, Journal of Rehabilitation Medicine 53(1), jrm00145. https:\/\/doi.org\/10.2340\/16501977-2775","DOI":"10.2340\/16501977-2775"},{"key":"ref54","doi-asserted-by":"crossref","unstructured":"Owolabi, E.O., Ferreira, K., Nyamathe, S., Ignatowicz, A., Odland, M.L., Abdul-Latif, A.-M. et al., 2023, \u2018Social determinants of seeking and reaching injury care in South Africa: A community-based qualitative study\u2019, Annals of Global Health 89(1), 5. https:\/\/doi.org\/10.5334\/aogh.4003","DOI":"10.5334\/aogh.4003"},{"key":"ref55","doi-asserted-by":"crossref","unstructured":"Pacheco Barzallo, D., O\u00f1a, A. & Gemperli, A., 2021, \u2018Unmet health care needs and inequality: A cross-country comparison of the situation of people with spinal cord injury\u2019, Health Services Research 56(suppl 3), 1429\u20131440. https:\/\/doi.org\/10.1111\/1475-6773.13738","DOI":"10.1111\/1475-6773.13738"},{"key":"ref56","doi-asserted-by":"crossref","unstructured":"Perry, C., Papachristou, I., Ramsay, A.I.G., Boaden, R.J., McKevitt, C., Turner, S.J. et al., 2018, \u2018Patient experience of centralized acute stroke care pathways\u2019, Health Expectations 21(5), 909\u2013918. https:\/\/doi.org\/10.1111\/hex.12685","DOI":"10.1111\/hex.12685"},{"key":"ref57","doi-asserted-by":"crossref","unstructured":"Pillay-van Wyk, V., Msemburi, W., Laubscher, R., Dorrington, R.E., Groenewald, P., Glass, T. et al., 2016, \u2018Mortality trends and differentials in South Africa from 1997 to 2012: Second national burden of disease study\u2019, Lancet Global Health 4(9), e642\u2013e653. https:\/\/doi.org\/10.1016\/S2214-109X(16)30113-9","DOI":"10.1016\/S2214-109X(16)30113-9"},{"key":"ref58","doi-asserted-by":"crossref","unstructured":"Portelli Tremont, J.N., Cook, N., Murray, L.H., Udekwu, P.O. & Motameni, A.T., 2022, \u2018Acute traumatic spinal cord injury: Implementation of a multidisciplinary care pathway\u2019, Journal of Trauma Nursing 29(4), 218\u2013224. https:\/\/doi.org\/10.1097\/JTN.0000000000000664","DOI":"10.1097\/JTN.0000000000000664"},{"key":"ref59","doi-asserted-by":"crossref","unstructured":"Rahayu, U.B., Wibowo, S., Setyopranoto, I. & Hibatullah Romli, M., 2020, \u2018Effectiveness of physiotherapy interventions in brain plasticity, balance and functional ability in stroke survivors: A randomized controlled trial\u2019, NeuroRehabilitation 47(4), 463\u2013470. https:\/\/doi.org\/10.3233\/NRE-203210","DOI":"10.3233\/NRE-203210"},{"key":"ref60","doi-asserted-by":"crossref","unstructured":"Richardson, A., Samaranayaka, A., Sullivan, M. & Derrett, S., 2021, \u2018Secondary health conditions and disability among people with spinal cord injury: A prospective cohort study\u2019, Journal of Spinal Cord Medicine 44(1), 19\u201328. https:\/\/doi.org\/10.1080\/10790268.2019.1581392","DOI":"10.1080\/10790268.2019.1581392"},{"key":"ref61","doi-asserted-by":"crossref","unstructured":"Rohwer, A., Toews, I., Uwimana-Nicol, J., Nyirenda, J.L.Z., Niyibizi, J.B., Akiteng, A.R. et al., 2023, \u2018Models of integrated care for multi-morbidity assessed in systematic reviews: A scoping review\u2019, BMC Health Services Research 23, 894. https:\/\/doi.org\/10.1186\/s12913-023-09894-7","DOI":"10.1186\/s12913-023-09894-7"},{"key":"ref62","doi-asserted-by":"crossref","unstructured":"Shank, C.D., Walters, B.C. & Hadley, M.N., 2017, \u2018Management of acute traumatic spinal cord injuries\u2019, in E.F.M. Wijdicks & A.H. Kramer (eds.), Handbook of clinical neurology, pp. 275\u2013298, Elsevier, Amsterdam.","DOI":"10.1016\/B978-0-444-63600-3.00015-5"},{"key":"ref63","unstructured":"Stats SA, 2023a. Census 2022, Statistics South Africa, Pretoria."},{"key":"ref64","unstructured":"Stats SA, 2023b, General household survey 2023 (statistical release P0318), Statistics South Africa, Pretoria."},{"key":"ref65","unstructured":"Stats SA, 2024, Profiling the socio-economic status and living arrangements of persons with disabilities in South Africa, 2011\u20132022 Report 03-01-37, Statistics South Africa, Pretoria."},{"key":"ref66","unstructured":"Tiwari, R., Ned, L. & Chikte, U., 2020, \u2018HRH planning for rehabilitation services: A focus to reduce inter-provincial inequities\u2019, South African Health Review 2020, 53\u201363."},{"key":"ref67","doi-asserted-by":"crossref","unstructured":"Visagie, S. & Swartz, L., 2018, \u2018\u201cThere is nothing wrong with me\u201d: Disability invisibility in a rural South African town\u2019, Disability and Rehabilitation 40(15), 1799\u20131807. https:\/\/doi.org\/10.1080\/09638288.2017.1313909","DOI":"10.1080\/09638288.2017.1313909"},{"key":"ref68","doi-asserted-by":"crossref","unstructured":"Walsh, M.E., Galvin, R., Loughnane, C., Macey, C. & Horgan, N.F., 2015, \u2018Factors associated with community reintegration in the first year after stroke: A qualitative meta-synthesis\u2019, Disability and Rehabilitation 37, 1599\u20131608. https:\/\/doi.org\/10.3109\/09638288.2014.974834","DOI":"10.3109\/09638288.2014.974834"},{"key":"ref69","doi-asserted-by":"crossref","unstructured":"Wiest, M.J., Gargaro, J. & Bayley, M.T., 2023, \u2018What is the pathway to the best model of care for traumatic spinal cord injury? Evidence-based guidance\u2019, Topics in Spinal Cord Injury Rehabilitation 29, 103\u2013111. https:\/\/doi.org\/10.46292\/sci23-00059S","DOI":"10.46292\/sci23-00059S"},{"key":"ref70","doi-asserted-by":"crossref","unstructured":"Wong, A.W.K., Garcia, S.F., Hahn, E.A., Semik, P., Lai, J.-S., Magasi, S. et al., 2021, \u2018Rasch analysis of social attitude barriers and facilitators to participation for individuals with disabilities\u2019, Archives of Physical Medicine and Rehabilitation 102(4), 675\u2013686. https:\/\/doi.org\/10.1016\/j.apmr.2020.09.390","DOI":"10.1016\/j.apmr.2020.09.390"},{"key":"ref71","unstructured":"World Health Organization (WHO), 2017, Rehabilitation 2030: A call for action \u2013 Meeting report, World Health Organization, Geneva."},{"key":"ref72","unstructured":"World Health Organization (WHO), 2022, Global report on health equity for persons with disabilities, World Health Organization, Geneva."},{"key":"ref73","doi-asserted-by":"crossref","unstructured":"Zeydi, E., Ghazanfari, A., Esmaeili, M.J., Mobayen, S., Soltani, M. & Fast, Y.E., 2022, \u2018Knowledge, attitude, and practice of Iranian nurses towards pressure ulcer prevention: A systematic review\u2019, Journal of Tissue Viability 31(3), 444\u2013452. https:\/\/doi.org\/10.1016\/j.jtv.2022.06.004","DOI":"10.1016\/j.jtv.2022.06.004"}],"container-title":["African Journal of Disability"],"original-title":[],"deposited":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T08:11:13Z","timestamp":1765440673000},"score":1,"resource":{"primary":{"URL":"https:\/\/ajod.org\/index.php\/ajod\/article\/view\/1726"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,12]]},"references-count":74,"journal-issue":{"issue":"0","published-online":{"date-parts":[[2025,1,1]]}},"URL":"https:\/\/doi.org\/10.4102\/ajod.v14i0.1726","relation":{},"ISSN":["2223-9170","2226-7220"],"issn-type":[{"value":"2223-9170","type":"print"},{"value":"2226-7220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,12]]},"article-number":"a1726"}}