Perceptions of and attitudes to the compulsory community service programme for therapists in KwaZulu-Natal

The success of Community Service programmes initiated globally to recruit health care professionals to provide services in under-served or rural areas depends largely on their attitudes, understanding of the programme's objectives, preparedness for working in these areas and their adaptability. This study assessed rehabilitation therapists' perception and attitude on commencement and completion of their compulsory Community Service programme in KwaZulu-Natal in 2005. Repeat observational cross sectional studies were conducted. A self-administered questionnaire was completed by all therapists on commencement and after completion of their Community Service. The proportion of therapists who indicated that they would work in the public sector in future declined from 50% at onset to 35% by exit and fewer (24%) said they would work in a rural area. Collecting a rural allowance was not associated (p = 0.78) with an expressed interest to work in a rural area or remain at the same institution (p = 0.32). There were significant differences in support and supervision provided between the professional groups (p < 0.001). Particular concerns centred on limited infrastructural support, supervision, training, resources available and language barriers in delivering a better rehabilitation service. Despite the challenges faced, Community Service therapists felt that they had made a difference and that their experience had been personally and professionally rewarding.