Challenges faced by staff managing learners with spina bifida in South African special schools.

Background: Special schools in South Africa play a dual role in education and healthcare for learners with disabilities, including those with spina bifida. However, the challenges faced by school staff in managing these learners are not well documented. Aim: This study explored the challenges faced by staff in managing learners with spina bifida in special school settings and gathered their recommendations for improving care and management. Setting: Special schools across two South African provinces. Methods: A qualitative descriptive case study approach was employed. Data were collected using an open-ended interview guide with 41 purposively selected participants: 22 educators, 7 health staff, 7 allied health professionals, and 5 housemothers. Follow-up in-depth interviews were conducted with 15 of the 41 participants: 6 educators, 3 allied health professionals, 4 health staff and 2 housemothers to further explore key concerns and reconsiderations. Thematic analysis was used to analyse data. Results: Staff reported significant challenges, including insufficient resources, a lack of clear health protocols, and poor academic outcomes for learners with spina bifida. Limited self-care skills and independence among learners, often exacerbated by parental neglect, were also highlighted. Participants emphasised the need for developmental support and stronger multidisciplinary collaboration. Conclusion: Addressing the complex needs of learners with spina bifida in special schools required targeted resource allocation, robust health protocols, and integrated support systems. Contribution: The study offers practical insights into improving the management and support of learners with spina bifida in special schools, contributing to policy and practice in low-and middle-income settings like South Africa.