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Purpose: Conflict and disability are closely associated; it is therefore significant to examine strategies at the grassroots-level for restoring the human rights of people with disabilities living in post-conflict societies. The aim of this study is to reveal the impact of and issues with community-based rehabilitation (CBR) in the Northern Province of Sri Lanka that was ravaged by civil war from 1983 to 2009.

Methods: The research was implemented in October 2016, in collaboration with a local NGO in the Mullaitivu district. A mixed-methods approach was followed, which included quantitative analysis of the NGO’s registration database of people with disabilities in the area (n=964), group interviews with 9 community rehabilitation committees (CRCs) of people with disabilities and their family members (n=118), and semi-structured interviews with clients of the CBR programme (n=5). Thematic analysis was applied to the narrative data.

Results: The quantitative analysis on clients of the NGO revealed that 60.9% of disabilities were related to war. Livelihood assistance was the most common type of self-reported need (44.6%). The qualitative analysis revealed that in communities with inadequate local resources, CRCs that had access to livelihood assistance made a positive impact on the socioeconomic conditions of people with disabilities and their family members. Potential issues were observed, such as the expectation of and dependence on the financial aid without self-help. Some people with disabilities would not attend CRCs if there were no financial benefits. As most of the participants had war-related disabilities, it is also possible that participation of people with intellectual and psychiatric disabilities unrelated to war may not have been promoted in some CRCs.

Conclusions: The CBR programme has had positive impacts on the living conditions of participants, albeit with some potential issues such as financial expectations and aid dependency. The authors argue that empowerment of people with disabilities and addressing socioeconomic inequality should be considered simultaneously.

“CBR Perspectives from Latin America” is a critical reflection on the multi-dimensional and changing nature of CBR, the perceived benefits, the conundrum of standardized approaches versus community driven processes, the nature of links between CBR and human rights, the resourcing of CBR and the difficulty inherent in taking a short term view in the evaluation of what is a long term process. Not so often are the experiences and perspectives from Latin America shared to a wider audience, making Dr. Grech’s work a remarkable achievement for the Region.”

This paper seeks to contribute to current debate on evidence-based practice and appropriate models of disability rehabilitation for people with disabilities in developing countries. Based on the authors' experience in, and evaluation of Community Based Rehabilitation (CBR) projects and research, they provide suggestions for utilising different kinds of evidence at different levels of CBR. The paper proposes four considerations. First, at the micro level of individual rehabilitation techniques, it recommends the judicious co-opting of available evidence from conventional evidence sources. Second, at the level of service planning, it suggests the need for conducting major syntheses of CBR evaluation reports for evidence. Third, it proposes the incorporation of values with research in consideration of issues at the model level. Finally, the paper proposes that in the case of CBR and similar approaches, new conceptualisations and methodologies are required in current understandings of evidence-based research and practice, which highlight the voice of people with disabilities, their family members and communities as key sources of evidence-related data."This paper seeks to contribute to current debate on evidence-based practice and appropriate models of disability rehabilitation for people with disabilities in developing countries...The paper proposes four considerations. First, at the micro level of individual rehabilitation techniques, it recommends the judicious co-opting of available evidence from conventional evidence sources. Second, at the level of service planning, it suggests the need for conducting major syntheses of CBR evaluation reports for evidence. Third, it proposes the incorporation of values with research in consideration of issues at the model level. Finally, the paper proposes that in the case of CBR and similar approaches, new conceptualisations and methodologies are required in current understandings of evidence-based research and practice, which highlight the voice of people with disabilities, their family members and communities as key sources of evidence-related data"

Asia Pacific Disability Rehabilitation Journal, Vol 19, No 2