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This article describes a study aimed at describing how successful different strategies for vocational rehabilitation could be implemented in rural areas of South Africa, and what the effects of these strategies would be. The strategies involved were the home industries approach, small business approach, and the hospital/clinic-based approach. These strategies were implemented in four rural communities by primary health care (PHC) level health workers over a period of 2 years. Results shows that the last two approaches lead to employment for small groups of patients, but that the income was not sufficient to replace disability grants. Psychosocial benefits and problems are described.