Caregiver Perceptions about Factors Impacting their Ability to Carry out Home-Based Therapy Programmes in Central Botswana: A Qualitative Study




Onset of the COVID-19 pandemic interfered with completion of all planned interviews.


Aim. Home-based programs, as an aspect of Community Based Rehabilitation (CBR), are provided as an integral part of remedial programming for children with disabilities in central Botswana. Observed difficulties with integration of these activities into daily living were deemed worthy of further investigation. The authors’ aim was to gain an in-depth picture of caregiver and therapist perceptions about the factors that impacted ability to carry out prescribed therapy. Methods. Purposive sampling was used. Therapists and caregivers were recruited for semi-structured qualitative interviews through active occupational therapy and physiotherapy contacts in central Botswana. Caregivers lived in different villages served by CBR and had been referred for therapy at the NGO branch office. Twelve questions for caregivers and 9 for therapists were presented during in-person meetings. Results. Interviews with 5 caregiver family members and 4 therapists were audio recorded and transcribed by the first author. Thematic analysis combined manual coding and NVivo software. Participant response themes described both direct and indirect influences on adherence to the home program. Direct influence themes were child characteristics, therapy competence and frequency, competing demands, and other issues. Indirect influence themes, which represented major impediments for carrying out a home program, were insufficient preparedness of healthcare providers, mismatched social welfare services, support system inadequacies, and language barriers. Conclusions. The findings of this study underscore the need for understanding the lived experiences of parents and other caregivers who are charged with carrying out home-based therapy programs for children with disabilities. Given this knowledge, workers in the CBR system can implement solutions in the community designed to educate policymakers and workers in the social welfare system while assisting clients to overcome barriers and advocate for their needs.

Author Biographies

Gerald Odhiambo Oler, Cheshire Foundation of Botswana

I received a diploma in occupational therapy from Kenya Medical training College in 2011 and passed the U.S. NBCOT - National Board for Certification in Occupational Therapy exam in 2014. My practice experience is in multicultural settings. Worked in Kenya for 2 years in community based rehabilitation and hospital-based care. Eight years to the present working in CBR in Botswana. While practicing in Botswana, I have been passionate about influencing policy through advocacy and promoting wellness in the general population as well as for people with disabilities. I have demonstrated leadership in several community projects, including wellness clubs, support groups and educational promotion for people with disabilities. I founded a chapter of the International Rotary Club in Central Botswana, which continues to bring together professionals and community members to solve challenges affecting the region. Success of these programs was achieved largely by means of building awareness through collaboration with stakeholders and the people.

Linda Niemeyer, Boston University

Professor Linda Niemeyer, OT, Ph.D., practiced for 25 years in Southern California as an occupational therapist in the areas of physical disability, pulmonary and cardiac rehabilitation, work-injury prevention and management, and wheelchair mobility. Dr. Niemeyer received a Ph.D. from the University of California at Riverside in the field of social psychology theory and research, with specialized studies in health psychology. The research project for her dissertation, which was entitled Identifying Psychosocial Indicators of High Risk for Delayed Recovery in an Outpatient Industrially Injured Population, arose from recognition of the need for more effective early case management for workers who had been injured on the job in the midst of a financial crisis and a managed-care revolution in workers'-compensation rehabilitation. Her dissertation research encompassed theories common to both occupational therapy and health psychology. As a reviewer for a professional journal, she provided constructive feedback to aspiring writers. Dr. Niemeyer has developed and taught one- to five-day workshops for professionals in the occupational therapy practice areas of cardiac rehabilitation, pulmonary rehabilitation, and return-to-work programs. Niemeyer is currently a lecturer in the distance-learning Post-Professional Occupational Therapy Doctorate (PP-OTD) program at Boston University's Sargent College, Department of Occupational Therapy and Rehabilitation Counseling. She has served as an academic mentor, course developer, and primary instructor in the masters and then doctoral program for 16 years.




How to Cite

Oler GO, Niemeyer L. Caregiver Perceptions about Factors Impacting their Ability to Carry out Home-Based Therapy Programmes in Central Botswana: A Qualitative Study. DCIDJ [Internet]. 2023 Oct. 18 [cited 2024 May 21];34(2):87-109. Available from:



Original Research Articles