There is emerging evidence that the public health sector is struggling to provide effective, efficient and equitable rehabilitation services, and this requires due attention to be paid to understanding what these capacity constraints are from a provider perspective. What is being witnessed is a conflict between strategic policies and operational structures, resulting in a widening gap between policy and practice. There are four key agencies that play a role in setting up rules guiding the delivery of rehabilitation services: Department of Health; Health Professions Council of South Africa; Department of Public Service Administration; and Tertiary training institutions. An analysis of the functioning of these four key institutions in the delivery of rehabilitation services is presented here to provide evidence of the constraining environment within which policies are required to be implemented.
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