A survey of speech-language pathologists’ dysphagia practice patterns in South Africa

PURPOSE: South Africa's quadruple burden of disease contributes to high rates of dysphagia across the lifespan, with speech-language pathologists often providing services in resource-limited contexts. Variability in training, resources, and clinical practice highlights the need for a national profile of dysphagia management. This study investigated dysphagia practice patterns and professional needs among South African speech-language pathologists. METHOD: An electronic survey was distributed via social media to speech-language pathologists providing dysphagia services. Convenience and snowball sampling were used. Responses from 124 participants were analysed descriptively, while qualitative data were analysed thematically. RESULT: Participants represented urban (78.8%) and rural (21.2%) settings across public (38.1%) and private (47.5%) sectors. Caseloads consisted primarily of adults with neurological conditions, particularly stroke and head injury. Dysphagia assessment relied largely on informal methods, with limited access to instrumental assessments, especially in public and rural contexts. Qualitative findings identified contextual constraints, training gaps, limited mentorship, and a need for contextually relevant guidelines. CONCLUSION: National strategies are needed to strengthen dysphagia service delivery through enhanced training, accessible mentorship, and contextually responsive guidelines that support equitable, safe, and evidence-informed care across diverse settings.