Seychelles recorded the highest Gross National Income (GNI) per capita in Africa as of 2023, at 16,940 U.S. dollars. The African island was, therefore, the only high-income country on the continent, according to the source's classification. Mauritius, Gabon, Botswana, Libya, South Africa, Equatorial Guinea, Algeria, and Namibia were defined as upper-middle-income economies, those with a GNI per capita between 4,516 U.S. dollars and 14,005 U.S. dollars. On the opposite, 20 African countries recorded a GNI per capita below 1,145 U.S. dollars, being thus classified as low-income economies. Among them, Burundi presented the lowest income per capita, some 230 U.S. dollars. Poverty and population growth in Africa Despite a few countries being in the high income and upper-middle countries classification, Africa had a significant number of people living under extreme poverty. However, this number is expected to decline gradually in the upcoming years, with experts forecasting that this number will decrease to almost 400 million individuals by 2030 from nearly 430 million in 2023, despite the continent currently having the highest population growth rate globally. African economic growth and prosperity In recent years, Africa showed significant growth in various industries, such as natural gas production, clean energy generation, and services exports. Furthermore, it is forecast that the GDP growth rate would reach 4.5 percent by 2027, keeping the overall positive trend of economic growth in the continent.

The average monthly salary for South Africans who were employed in the formal non-agricultural sector was just over 26,800 South African rands (comparable to roughly 1,500 U.S. dollars) in November 2023, which represented a yearly increase of tw0 percent. During the period under review, the overall growth trend was positive, with the earnings increasing by 24.4 percent from 21,500 South African rands (approximately 1,180 U.S. dollars) in November 2018.    Minimum wage and highest-paid professions    Starting in March 2023, the minimum hourly wage in the country increased to 25.42 South African rands (comparable to 1.40 U.S. dollars), which represented an increase of 9.6 percent from 23.19 South African rands (1.27 U.S. dollars) per hour in the preceding year. On the other hand, professionals in executive and change management positions were paid the highest salaries in South Africa, with an average of 74,000 U.S. dollars yearly. Individuals with jobs in retail, trade, and craft followed, receiving an average of 66,000 U.S. dollars per annum.       Highest unemployment among Black South Africans In 2022, the unemployment rate in South Africa was nearly 30 percent following an increasing trend since 2008. The rate was highest among Black South Africans reaching as high as 36.8 percent in the second quarter of 2023. Moreover, Colored South Africans followed with around 22 percent, while white South Africans had a much lower unemployment rate of over 7 percent.

As of 2024, an individual living in South Africa with less than 1,109 South African rand (roughly 62.14 U.S. dollars) per month was considered poor. Furthermore, individuals having 796 South African rand (approximately 44.60 U.S. dollars) a month available for food were living below the poverty line according to South African national standards. Absolute poverty National poverty lines are affected by changes in the patterns of household consumers and fluctuations in prices of services and goods. They are calculated based on the consumer price indices (CPI) of both food and non-food items separately. The national poverty line is not the only applicable threshold. For instance,13.2 million people in South Africa were living under 2.15 U.S. dollars, which is the international absolute poverty threshold defined by the World Bank. Most unequal in the globe A prominent aspect of South Africa’s poverty is related to extreme income inequality. The country has the highest income Gini index globally at 63 percent as of 2023. One of the crucial obstacles to combating poverty and inequality in the country is linked to job availability. In fact, youth unemployment was as high as 49.14 percent in 2023.

Objective

To synthesize research published on vocational rehabilitation (VR) interventions offered in institutions, by occupational therapists, to mental health service users (MHSUs) with chronic mental illness, in low-income to upper middle-income countries (L-UMIC).

Design

This scoping review used Arksey and O'Malley's methodological framework, the Preferred Reporting Items for Systematic Reviews extension for Scoping Reviews (PRISMA-ScR) and Joanna Briggs scoping review guidelines.

Data Sources

We searched PsycInfo, EBSCOhost, HINARI, Google scholar, Medline, CINAHL, PubMed, Cochrane Library, Scopus, Science Direct and Wiley online library between 15 July and 31 August 2021.

Eligibility Criteria

Sources, published in English between 2011 and 2021, on institution-based VR in occupational therapy for MHSUs who had chronic mental illness in L-UMIC were included. We included primary studies of any design.

Data extraction and synthesis

Three reviewers used Mendeley to manage identified references, Rayyan for abstract and full text screening, and Microsoft Excel for data extraction. Data was sifted and sorted by key categories and themes.

Results

895 sources were identified, and their title and abstracts reviewed. 207 sources were included for full text screening. 12 articles from 4 countries (South Africa, India, Brazil & Kenya) were finally included. Types of VR intervention included supported employment, case management and prevocational skills training. Client centeredness, support and empowerment were the key VR principles identified. Teaching of illness self-management, job analysis and matching, job coaching, trial placement, and vocational guidance and counseling, were the main intervention strategies reported.

Conclusions

VR intervention in institutions for MHSUs in L-UMIC revealed the multidimensional uniqueness of individual MHSU's vocational ability, needs and contexts. The interventions allowed client-centered approaches that offer support, and empowerment beyond the boundaries of the institutions. Occupational therapists offering VR need to expand their interventions beyond their institutions to contexts where MHSUs are working or intending to work.