Laeeqa Sujee

Background: Social accountability represents the social contract between medicine and society, encouraging healthcare professionals (HCPs) to address social and health-related issues. The importance of integrating social accountability into curricula is widely recognised, but there is a lack of comprehensive mapping of the specific elements that should be included. Objectives: To identify the key elements of social accountability that should be integrated into undergraduate health sciences curricula to develop socially accountable HCPs. Method: The scoping review was conducted following the Joanna Briggs Institute Reviewers’ Manual 2015 for scoping reviews. A comprehensive search was employed using various keyword combinations and search strings, inclusive of published and grey literature from the past 15 years. Studies were systematically charted and analysed. Results: A rigorous screening process resulted in 47 studies being included in the review. Majority of the studies were qualitative, with the highest number of studies originating from Canada, South Africa, and the United States, as well as several multi-country studies. Equity emerged as the most frequently mentioned value, while cost-effectiveness was discussed the least. Conclusion: The scoping review demonstrates that embedding equity-driven approaches, community engagement, interprofessional collaboration and transformative learning in healthcare systems and tertiary institutions is vital. Addressing these priorities through undergraduate health sciences training can foster more inclusive, responsive and effective healthcare delivery, and improve health outcomes. Clinical implications: Integrating the identified elements of social accountability into undergraduate health sciences curricula may lead to improved patient outcomes, reduced health disparities, and more effective, patient-centred care.

Introduction: Stroke is one of the global leading causes of disability, with a higher prevalence at a younger age in sub-Saharan Africa. Returning to functional status is a primary goal of rehabilitation for stroke survivors. However, the cost of intensive rehabilitation is often a barrier for the under-resourced in South Africa. Patient presentation: This article describes the individualised ‘return-to-function’ approach to rehabilitation and its outcomes for five stroke survivors delivered through a non-profit public–private partnership in a low-income community in South Africa. Management and outcome: A retrospective case series of stroke survivors who participated in the Bounce Back Journey (BBJ) programme between 2019 and 2021 was conducted. The beneficiaries’ ages ranged from 21 to 55 years; two were females and three were males. The goals and outcomes of five stroke survivors with impairments, functional limitations and participation restrictions admitted into the BBJ programme were evaluated through standardised outcome measures. All the beneficiaries required financial support and extensive rehabilitation to return to a functional life. All showed improved outcomes in functional independence and health-related quality of life at discharge. Depressive symptoms clinically deteriorated in one patient. At discharge, all participants faced challenges finding opportunities to return to work. Conclusion: The case series demonstrates how an alternative community-based rehabilitation programme has the potential to improve functionality, health-related quality of life and mental health. Contribution: A low-cost, community-based, intensive rehabilitation programme can improve functionality, but return to work and community re-integration opportunities remain limited. Keywords: stroke; goal setting; return to work; quality of life; participation; mental health.