Barriers and facilitators of return to work for loss of income claimants: Healthcare workers' perspectives.

Background: Road traffic accidents (RTAs) are a global and public health concern affecting a third of the world's population mainly in low- to middle-income countries, particularly affecting young people. Returning to work (RTW) following an RTA is essential for better health and financial outcomes. The motor vehicle accident (MVA) Fund Botswana assists loss-of-income (LOI) claimants with medical assistance, compensates for loss, advocates and facilitates RTW. Objectives: The study aims to identify barriers to and facilitators of RTW for LOI claimants as experienced by health care workers (HCWs). Method: A qualitative explorative design included six healthcare workers who had worked with the MVA Fund on RTW for at least 5 years through purposive sampling. Data collection was done using a focus group discussion. Thematic analysis was conducted using Atlas.ti, with data interpretation guided by the ecological case management model. Results: The main themes were healthcare systems, legislation and insurance systems, personal and workplace systems, which were further classified into eight subthemes relating to barriers and facilitators.Barriers included ineffective case management and how claimants perceived work. Facilitators included clear insurance RTW guidelines and workplace support and education level. Conclusion: Successful RTW can be achieved through multidisciplinary collaboration of HCWs. While legal and healthcare systems play vital roles in RTW, personal factors and workplace systems cannot be ignored. Contribution: Understanding the barriers to and facilitators of RTW will assist in implementing RTW interventions to improve patient outcomes, health, livelihoods, quality of life and guide RTW operations to ensure a coordinated process in the insurance industry in Africa.