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National Health Insurance interprofessional practice implementation in hand rehabilitation service delivery in South Africa

Monique M. Keller
South African Journal of Physiotherapy | Vol 80, No 1 | a1969 | DOI: | © 2024 Monique M. Keller | This work is licensed under CC Attribution 4.0
Submitted: 18 August 2023 | Published: 23 April 2024

About the author(s)

Monique M. Keller, Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, Parktown, South Africa


South Africa’s current healthcare system is unequal and inefficient, with 71% of the population accessing underfunded public healthcare facilities. The imminent National Health Insurance (NHI) aims to balance the inequality between private and public health services by providing universal healthcare. The high levels of road accidents, violence and injuries in South Africa, being one of the quadruple burdens of diseases frequently causing hand injuries with resultant devastating economic and functional implications without rehabilitation services, are concerning. The plea is that for specialised injuries, such as hand injuries, the NHI implementation requires innovative interprofessional health education and practice when managing individuals who sustained hand injuries optimally to return to preinjury functioning. When considering the devastating burden of mismanaged hand injuries on all levels of the International Classification of Functioning, Disability and Health (ICF) framework, all South Africans deserve rehabilitation by physiotherapists and occupational therapists based on each occupation’s unique strengths. Anecdotally, a lack of interprofessional undergraduate and postgraduate hand rehabilitation education and hand-injured patient management exists in South Africa, highlighting the need for urgent change towards future practice and NHI. This commentary aims to apply the ICF core sets to inform interprofessional hand rehabilitation delivery by physiotherapists and occupational therapists.

Clinical implication: Interprofessional rehabilitation framed in the ICF Core Set, accompanied by inclusive interprofessional education opportunities according to the Health Professions Council of South Africa (HPCSAs) scope of practice, will benefit South Africans who sustained hand injuries to fully recover and maximise their functional performance considering the type of injuries sustained.


physiotherapy; National Health Insurance; hand therapy; interprofessional practice; interprofessional education; International Classification of Functioning, Disability and Health; ICF core sets.


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