Outcome measurement: Design of a social impact framework to measure shifts in the ecosystem for inclusion.

Children with disabilities need comprehensive intervention spanning health, education, and social systems from infancy through adulthood, with ongoing assessment of outcomes. While assistive technology is crucial, it must be complemented by inclusive learning options and other systemic interventions. Bronfenbrenner's Ecological Systems Theory guides this approach. A project in South Africa's Northern Cape Province utilized Acumen's Lean Data methodology for monitoring and evaluation. This methodology emphasizes rapid, technology-enabled data collection to inform stakeholders effectively. The project focused on disability awareness, referral systems, assistive technology provision, and early childhood development, adapting programs for various stakeholders and virtual delivery during COVID-19 lockdowns. Results underscored the interconnectedness of assistive technology with broader inclusion efforts and the importance of adaptability and continuous assessment. Further research is recommended to explore the project's role in fostering disability inclusion comprehensively. This ecosystemic approach highlights the necessity of holistic intervention and ongoing evaluation for sustainable social transformation and inclusion.

A qualitative exploration of the uses of the International Classification of Functioning, Disability and Health at an inpatient neurorehabilitation facility in the Western Cape, South Africa.

PURPOSE OF THE STUDY: The aim of the study was to describe how healthcare professionals at a neurorehabilitation facility currently use the International Classification of Functioning, Disability and Health (ICF) and to identify further possibilities for its future use. METHODS: The study followed an interpretive description approach. Data were collected through four focus group discussions with 21 participants, all health care practitioners, at the study facility. Thematic analysis was conducted by coding the transcripts and generating themes. FINDINGS: Three themes were generated: (1) Current use and gaps in use of the ICF, (2) a non-conducive environment and (3) using the ICF to facilitate holistic, patient-centred management. Current use of the ICF was limited. Gaps in use of the ICF was especially evident in goal setting practices. Goals were generic in nature and did not address participation and the environment. A lack of knowledge, debilitating interpersonal relationships and an unsupportive organisational culture created an environment non-conducive to the implementation of the ICF. Participants felt that the ICF can assist them to work more patient-centred. CONCLUSION: Participants perceived that the ICF has the potential to improve service delivery at the facility. The implementation process must be well structured, focus on practical use and be supported through an enabling environment created by management.IMPLICATIONS FOR REHABILITATIONThe ICF is not being optimally used in clinical rehabilitation practice, however healthcare practitioners perceive the ICF to have the potential to improve rehabilitation service delivery.Concerted action is required at institutional, interpersonal and individual level to create a conducive environment that facilitates the use of the ICF during rehabilitation service delivery.The ICF can be used to construct a team assessment document that promotes patient-centred goal setting and improves interdisciplinary communication.