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Community-based rehabilitation : opportunity and challenge

HARTLEY, Sally
et al
November 2009

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This article presents information about community based rehabilitation (CBR) and highlights the present opportunities and challenges. The article details the critiques of CBR and the recent emphasis to redress the balance and improve the evidence base. The article states that "CBR is now ready to be examined more rigorously, applied more consistently, and integrated more effectively into national and international policy making"
The Lancet, Vol 274

Inclusive local development : how to implement a disability approach at local level

PLANTIER-ROYON, Eric
November 2009

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This policy paper outlines Handicap International's mandate and values in the field of the inclusive local development. It presents the organisation's actions, choices and commitments in the area of local inclusive development, and provides the six main components of projects. Future possibilities and potential limitations are also highlighted. This policy paper is useful to people who have an interest in disability rights and inclusive local development initiatives

The efficacy of community based rehabilitation for children with or at significant risk of intellectual disabilities in low and middle income countries : a review

ROBERTSON, Janet
EMERSON, Eric
HATTON, Chris
August 2009

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"The aim of the present review is to summarise evidence regarding the efficacy of CBR in relation to one particular ‘high risk’ group of disabled children; children with intellectual disabilities (ID)...Only 10 studies were identified for inclusion in the review of research on the effectiveness of CBR for children and adolescents with ID and these are summarised in Appendix Two. An examination of reviews on the effectiveness of CBR for all people with disabilities points to two main reasons for this low level of evidence. Firstly, CBR has not been the subject of a significant amount of rigorous evaluation. Secondly, children and adolescents with ID have not been the recipients of significant amounts of CBR. We will discuss the reviews on the effectiveness of CBR generally and indicate what they say about ID before outlining the extremely small amount of information available on the effectiveness of CBR for children and adolescents with ID"
CeDR Research Report 2009:4

Evaluation of support to CBR programme in Lesotho

MENDIS, Padmani
KACHINGWE, Andrew
KHABELE, Mabele Irene
July 2009

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This evaluation report of a CBR programme in Lesotho "looked particularly at relevance, efficiency and coherence rather than at impact, looking firstly at management and implementation and the role of disabled people and their organizations. Two other areas - education and gender -were looked at for their relevance. A fifth area that emerged during the evaluation as being in urgent need of support is livelihoods. At the grass-roots, implementation by village volunteers (LSs) has brought results for many disabled people"

Overcoming the barriers for participation by the disabled : an appraisal and global view of community-based rehabilitation in community development

OLAOGUN, M O B
NYANTE, G G G
AJEDIRAN, A
June 2009

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"The number of people with disability worldwide, and particularly in the developing countries, is increasing due to wars, conflicts, vehicular accidents, chronic diseases, mental impairment, birth defects and malnutrition. Many of these people face participation-restriction in activities of life. This paper appraises the emergence and the global view of community-based rehabilitation (CBR). The review and remodelling of CBR in developing countries and its inclusion in community development will enhance the reintegration of the disabled individuals into the society"
African Journal of Physiotherapy and Rehabilitation Sciences, Vol 1, No 1

CBR policy development and implementation

HARTLEY, Sally
OKUNE, Joan
Eds
2009

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This book provides an overview of current community-based rehabilitation (CBR) knowledge and shows how this information has been interpreted and implemented in the African context. It has been developed from conference presentations and discussions that took place in South Africa in 2007. It is useful for people interested in general CBR information and CBR in Africa

The influence of HIV/AIDS on community-based rehabilitation in dar es salaam, Tanzania

BOYCE, William
COTE, Laurence
2009

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Community-Based Rehabilitation (CBR) is the method of choice for delivering services for people living with disabilities in many countries. HIV/AIDS is changing the daily lives of many women by adding to their responsibilities. How realistically can such women participate actively in community development activities like CBR? This paper examines the impact of HIV/AIDS on CBR in Dar es Salaam, Tanzania. Observational sessions and individual interviews were conducted with caregivers of children with disabilities, CBR workers and managers over a three month period. Among the findings was a significant decrease in CBR activities in families affected by HIV/AIDS. This change in family priorities was due to better knowledge of acute diseases and increased stigma of HIV/AIDS in comparison to disability. Older CBR workers were more likely to incorporate elements of HIV/AIDS care with CBR, while younger CBR workers were more likely to avoid HIV/AIDS support. The ability of CBR workers to adapt their working habits to an environment with high HIV/AIDS prevalence is linked to their sense of skill competence and their knowledge/beliefs about risk of infection. Further integration of CBR work with general health development initiatives may improve this situation.

The role and position of disabled people’s organisations in community based rehabilitation : balancing between dividing lines

CORNIEJE, Huib
2009

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The role of disabled people in CBR is increasingly being seen as of vital importance for the success of CBR. In actual fact participation of disabled people and self advocacy have become two of the principles of CBR as seen by the World Health Organisation and associated organszations behind the new CBR thinking.

This paper deals with the position and role of disabled people themselves in CBR programmes. It critically looks into the role Disabled Peoples’ Organisations in terms of promoting equal access to essential and acceptable quality of rehabilitation programmes for all and especially the poor of this world. It is argued that DPOs should join the ranks of those (professionals) who are committed to ensure that rehabilitation becomes accessible to all. The current global situation of an ever widening gap between the ‘ones who have and those who don’t have’ requires a critical reflection on ones’ own work in CBR and DPO development. We cannot permit ourselves anymore a division among those who are disabled and those who are non-disabled as there are other divides among groups of people that are by far more profound and serious to the majority of disabled people worldwide.

While the urban elite of disabled people who live in a conflict-free, open and democratic society may be well concerned with issues such as accessible tourism, CBR as essential service provision is often unavailable for the poor rural masses and those living under illegal conditions in slums of the cities of Africa, Asia and South America. CBR as philosophy seeks for solidarity with those who live under appalling conditions; threatened by conflict, eviction and hunger. This paper calls for collaboration between DPOs and the CBR movement in order to address diversity and ensure that the implementation of basic human rights are truly addressed.

 

 

Asia Pacific Disability Rehabilitation Journal, Vol 20, No 1

Physical therapy roles in community-based rehabilitation : a case study in rural areas of north eastern Thailand

NUALNETR, Nomjit
2009

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his action research aimed to explore how physical therapists could enhance the quality of life for persons with disabilities via a community-based rehabilitation (CBR) strategy. The study was conducted in two rural sub-districts in northeastern Thailand. In each sub-district, several group meetings were arranged for persons with disabilities and their families, and various community members. Participants were encouraged to discuss their perception of problems of the current rehabilitation services for persons with disabilities. Strategies to manage all problems were collaboratively identified and were implemented in order of priority according to the importance of the problem. The outputs of CBR were evaluated by interviews and observation. The findings revealed that physical therapists had numerous roles in CBR, depending on the community’s circumstances. They need a high degree of flexibility and a wide range of skills to contribute to CBR. The preparation of such physical therapists requires development of a more client-centered community-oriented education programme.

 

 

Asia Pacific Disability Rehabilitation Journal, Vol 20, No 1

Mental retardation, poverty and community based rehabilitation

HELANDER, Einar
2009

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"This study follows an analysis, based on a review of the Swedish programme for mental retardation during the period 1930-2000. It is concluded that in Sweden a very large proportion of mild and moderate mental retardation has been eliminated though the combination of poverty alleviation with a community-based rehabilitation programme. For these situations a pro-active programme analysing and meeting the needs of the target groups should be useful as a means to achieve poverty alleviation"
Iranian Rehabilitation Journal, Vol 7, No10

Effectiveness of an integrated model of community based rehabilitation on the quality of life of people with disabilities residing in urban slums south India

NAGARAJAN, Guru S
2009

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"Considering the need for more information on current practice and research in CBR, the researcher studied the effectiveness of an integrated model of CBR set up in the Christian Medical College, Vellore, South India (VCBR). The objectives of this study were to generate theory on the value of an `integrated model' that uses an educational strategy and to explore the value of secondary and tertiary care services for PWD in a community based rehabilitation programme for the improvement of their quality of life. A 'Case Study' design was used...The study found that an integrated model of CBR that uses an educational strategy, has good links with secondary/tertiary care centres and makes use of social network/capital, which is available in the community, improved the overall QOL of PWD"

Is doing good "good" : professional motives vs. community needs

POLLARD, Nick
SAKELLARIOU, Dikaios
2009

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"This paper offers a critical discussion of the goodness of fit between professional motives and community needs in the field of community-based rehabilitation (CBR). Data were drawn from the authors’ involvement in a survey of occupational therapists involved in CBR and a search of CINAHL, PsychInfo and Medline online databases for related descriptive and analytical articles. Due to cultural differences and time constraints CBR professionals often are, and remain, ‘outsiders’ to the community they are working with. The focus of CBR is sometimes uncertain. Professional motives do not always meet community needs and good intentions do not necessarily transpire into sustainable, culturally appropriate action. The involvement of the community in all stages of programme development and implementation is important both to ensure relevancy and build alliances with the community. CBR needs to be approached and evaluated as a unique area of professional practice"

 

Asia Pacific Disability Development Journal, Vol 20, No 2

Popular theater [Chapter 48]

WERNER, David
2009

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This chapter presents information about how community theater can be used to raise awareness about specific needs of disabled persons or to gain greater participation of local people in a community rehabilitation programme. It also highlights that community theatre can be a good method for educating people about important preventive measures and recommends that actors can be disabled persons, parents of disabled children, health workers, rehabilitation workers, schoolchildren, or any combination of these
Chapter 48 of "Disabled Village Children" by David Warner

Playgrounds for all children [Chapter 46]

WERNER, David
2009

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This chapter presents information about how to involve local people in building low-cost rehabilitation playgrounds that should be built for use by all children, both disabled and non-disabled. Examples of playgrounds and equipment are provided
Chapter 46 of "Disabled Village Children" by David Warner

Philippine CBR manual : an inclusive development strategy

MCGLADE, Barney
MENDOZA, Veronica Ester
Eds
2009

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This is an executive summary of a manual that is intended as a guide to decision makers in Local Government Units on how to institutionalise and implement programme that ensure the inclusion of persons with disabilities in all activities in the community – and ensure these activities are part of the annual work and financial plan of government and other local groups.  While the manual is intended for government decision makers, it can also be used by CBR workers and managers to understand inclusion, CBR in the rights-based context, the historical perspective and evolving definition of disability as well as how to start CBR, how to organize DPOs and communities, and how to undertake training and advocacy

The publisher has given permission for the uploaded document to be reproduced and made publicly available on the Source website

The efficacy of community-based rehabilitation programmes for adults with TBI

EVANS, L
BREWIS, C
October 2008

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"The aim of this systematic review was to investigate the factors which influence the efficacy of community-based rehabilitation programmes in improving the quality of life and functional capacity of adults with severe TBI. This was achieved by identifying the different types of interventions used in community settings, and by exploring their outcomes, taking into account differences in methodological design and quality"
International Journal of Therapy and Rehabilitation, Vol 15, No 10

Systematic synthesis of community-based rehabilitation (CBR) project evaluation reports for evidence-based policy : a proof-of-concept study

KUIPERS, Wim
WIRTZ, Sheila
HARTLEY, Sally
March 2008

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This article presents the methodology and findings from a proof-of-concept study undertaken to explore the viability of conducting a systematic, largely qualitative synthesis of evaluation reports emanating from Community Based Rehabilitation (CBR) projects in developing countries, using 36 disability and development projects in 22 countries

Community based rehabilitation programmes : monitoring and evaluation in order to measure results

CORNIELJE, Huib
VELEMA, Johan P
FINKENFLUGEL, Harry
March 2008

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This paper aims to help develop "methodologies that will help to measure results of Community Based Rehabilitation programmes...The article places considerable importance on management information systems and monitoring, since it is believed that evaluation will greatly benefit from both the existence of baseline data as well as a well-developed and well-implemented information system. The present article emphasises the need for participatory processes in the development of baseline data and information systems. Four key areas for measuring CBR are highlighted: people, power, public society and partnerships. Finally, a tool is presented in order to evaluate (or monitoring and evaluation) systematically"
Leprosy Review, Vol 79, No 1

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