Perspectives of service providers on aftercare service provision for persons with substance use disorders at a Rural District in South Africa

Background

Aftercare programs for people with substance use disorders (PWSUD) are frequently challenged with a number of overlapping obstacles, including uncertain policy consequences and a lack of resources. Despite demographic variety, service providers in South Africa are obligated to offer aftercare programs that effectively reintegrate people with PWSUD into society, the workforce, family, and community life, as specified by Act No. 70 of 2008. Little is known about the availability of aftercare services in South Africa, particularly in rural areas. This paper investigates service providers' perceptions on providing aftercare services for PWSUD in a rural district.

Methods

In a rural region of South Africa, a qualitative exploratory research methodology was used, including semi-structured interviews and focus group discussions with forty-six service providers from governmental and non-governmental entities, spanning from implementation to policy level of service provision. A logical strategy was used to evaluate the data thematically. The study's aims and objectives employed Beer's Viable Systems Model as a theoretical framework, and codes were predefined from the questions. The qualitative data analysis program NVivo Pro 12 directed the structuring and further analysis of the data.

Results

The data sets produced four themes. Theme 1 on reflections on the interactional status of aftercare services and program content recognised the achievements and shortcomings of aftercare interventions, as well as appropriate aftercare service recommendations. Themes 2, 3, and 4 exhibit service provision reflections from implementation to policy level, namely identifying current obstacles to aftercare service provision, locating systemic facilitators to aftercare service provision, and corresponding aftercare system recommendations.

Conclusions

The overlapping structural challenges of delivering aftercare services in a rural South African environment were obvious. In this remote region, there were few facilitators for service provision. At all levels of service provision, service providers face significant structural impediments. Policies for the enforcement of aftercare services are essential to enhance the aftercare system. Furthermore, an aftercare model that is integrated into current services, family-centred, sensitive to the rural environment, and supports stakeholder engagement might help to build and sustain the aftercare system and service provision.