Resources search

Purpose: There is limited guidance available on the best ways to evaluate community-based rehabilitation (CBR) programmes. In this paper, we share lessons learned on suitable evaluation strategies for CBR through a South African programme evaluation.

Method: An empowerment evaluation of an early childhood development programme was conducted in April 2012. At the end of the field visit, parents, staff members and managers provided feedback anonymously about what they liked and disliked about the evaluation, and offered their suggestions. The principal investigator documented the evaluation process in a journal, recording the barriers and facilitators encountered, the participation of the 3 groups and the effectiveness of the different strategies used. The data analysis followed the principles of grounded theory.

Results: The main lessons learned about CBR programme evaluation are associated with strategies to: 1) foster active participation, 2) collect accurate and credible information, 3) build local capacity, and 4) foster sustainable partnerships. Time spent to promote a positive learning spirit and the use of participatory tools with all groups appeared critical to active engagement in evaluation activities. Sharing tools and experiences in context built more local capacity than was achieved through a formal workshop. The findings also highlight that a flexible model, multiple data collection methods, and involvement of all relevant stakeholders maximise the information gathered. Sensitivity to the impact of culture and to the reactions generated by the evaluation, along with ongoing clarifications with local partners, emerged as core components of sustainable partnerships.

Conclusion: CBR evaluators must use a variety of strategies to facilitate active engagement and build local capacity through the evaluation process. Many of the strategies identified relate to the way in which evaluators interact with local stakeholders to gain their trust, understand their perspectives, facilitate their contribution, and transfer knowledge. Further research is needed on how toconduct empowering CBR programme evaluations.

Purpose: This paper seeks to contribute to discussion on the understanding and measurement of empowerment of people with disabilities in developing countries. A novel, text analysis approach was used to depict the way in which empowerment is characterised in conventional measures in Western settings. This was then compared with depictions and analyses of the way in which empowerment is characterised in documents that have more relevance to developing countries.

Method: First, computer-based content and concept analysis was applied to three key empowerment measures. This was compared with analysis of responses to a recent online survey of empowerment conducted by the United NationsDepartment of Economic and Social Affairs (UN-DESA). Visual representations in the form of “word clouds” were generated to depict key concepts within each data source. Second, to provide specific detail regarding how empowerment has been described in documents which relate to developing countries, more detailed computer-assisted lexical analysis was performed on the text of responses to the UN-DESA survey, and on the text of the Empowerment component of the CBR Guidelines.

Results: Initial “word clouds” illustrated considerable discrepancy between concepts inherent in the three most relevant empowerment measures when compared with responses to the UN-DESA survey relating to empowerment in a development context. Subsequent lexical analysis depicted greater specificity and ranked the concepts associated with empowerment in key disability and development-related documents.

Conclusions: Conventional Western measures of individual empowerment may not adequately encompass the broader social, economic and community orientation of empowerment as described in documents from disability and development circles. Further research is required to substantiate these novel and speculative indications.

Purpose: The aim of this study was to determine the relationship between gross motor function and quality of life among children with Cerebral Palsy (CP).

Method: This observational analytical study with cross-sectional design, was conducted at Yayasan Pembinaan Anak Cacat (YPAC) Bandung, Sekolah Luar Biasa (SLB) Cileunyi, and Paediatric Neurology Clinic of Dr. Hasan Sadikin Hospital Bandung, Indonesia, from March 2011 to September 2012. Gross motor function was assessed using Gross Motor Function Scale (GMFCS). Cerebral Palsy-Quality of Life (CP-QOL) questionnaire for parent-proxy version was used to assess quality of life of children with CP. Statistical analysis was done using Spearman rank test to determine the relationship between variables.

Results: Participants were 31 children with CP, between 4 -12 years of age. The most common type of CP was spastic quadriplegia (17 of the 31 children). Around 17 children had mild disability (GMFCS level I and II), 3 children had moderate disability (GMFCS level III), and 16 children had severe disability (GMFCS level IV and V). Majority of the parents had senior high school level education. Most of the fathers were self-employed while most of the mothers were housewives. Gross motor function was not significantly correlated to quality of life in general in children with CP (rs=-0.153, p=0.205). Although gross motor function was significantly correlated to pain and the impact of disability (rs=-0.313, p=0.043), other aspects of quality of life (social well-being and acceptance, feeling about functioning, participation and physical health, emotional well-being and self-confidence, access to services, and family health) were not significantly correlated (p>0,05) to it.

Conclusions: Gross motor function in children with CP was correlated to pain and the impact of disability domain of quality of life.