Expert Consensus on Components of an Evidence-Based Framework to Facilitate Self-Employment for Persons With Disabilities: A Delphi Study.
Luther Lebogang Monareng, Shaheed Mogammad Soeker, Deshini Naidoo
Twenty-one South African experts reached consensus on a five-part framework to guide occupational therapists in helping people with disabilities start and sustain small businesses.
It is a planning tool, not a tested intervention, and is context-specific.
Key findings
1Experts across three Delphi rounds agreed on five components for a self-employment framework: key features of the tool, legal alignment, key role players, the characteristics and roles of persons with disabilities, and four facilitation steps with a case manager. Overall Round 2 consensus was 4.54 out of 5 (90.80%).
2The four facilitation steps (situation analysis, intervention, placement, stabilisation) require a dedicated case manager to oversee, and participants agreed tangible progress should be visible within 3 to 6 months, with monitoring for at least a year.
3The tool is explicitly designed for use by occupational therapists, should be nonprescriptive and adaptable to individual and contextual needs, and participants recommended piloting it in diverse practice settings before wider rollout.
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What it does not show
Small expert panel: 21 recruited, dropping to 15 by the final round, which the authors acknowledge limits transferability. Expert consensus, not empirical evidence: no client outcomes were measured, so there is no evidence that using this framework improves employment or business success for persons with disabilities. South African context: the legal references, institutional names, and service landscape are specific to South Africa; applicability elsewhere is untested. Attrition across rounds (21 to 19 to 16 to 15) means the final consensus reflects a shrinking subset of the original panel. The framework has not been piloted or implemented; the authors themselves call the user's guide the critical next step. The authors note that staff shortages and budget cuts in South African health services may make implementation difficult in practice.
Declared interests
Funded by South Africa's National Research Foundation, the University of KwaZulu-Natal's University Capacity Development Grant, the UKZN Step Up Programme, the Department of Higher Education and Training, and the Newton Fund. The authors declare no conflicts of interest. No commercial sponsor is involved.
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