associate prof theresa lorenzo school of health and rehabilitation sciences university of cape town
TRANSCRIPT
![Page 1: Associate Prof Theresa Lorenzo School of Health and Rehabilitation Sciences University of Cape Town](https://reader035.vdocuments.net/reader035/viewer/2022070323/56649e205503460f94b0bf81/html5/thumbnails/1.jpg)
Associate Prof Theresa LorenzoSchool of Health and Rehabilitation Sciences
University of Cape Town
![Page 2: Associate Prof Theresa Lorenzo School of Health and Rehabilitation Sciences University of Cape Town](https://reader035.vdocuments.net/reader035/viewer/2022070323/56649e205503460f94b0bf81/html5/thumbnails/2.jpg)
Definition of Disability - UN Convention on Rights of Persons with Disabilities
Persons with disabilities include those who have long-term physical, mental, intellectual or sensory impairments which in interaction with various barriers may hinder their full and effective participation in society on an equal basis with others (United Nations, 2006)
![Page 3: Associate Prof Theresa Lorenzo School of Health and Rehabilitation Sciences University of Cape Town](https://reader035.vdocuments.net/reader035/viewer/2022070323/56649e205503460f94b0bf81/html5/thumbnails/3.jpg)
Community Based Rehabilitation (CBR) A strategy within general community development
forEqualisation of opportunitiesRehabilitationPoverty reduction and Social inclusion of children and adults with
disabilities
Emphasis on human rights
Complex form of change (WHO, 2004)
![Page 4: Associate Prof Theresa Lorenzo School of Health and Rehabilitation Sciences University of Cape Town](https://reader035.vdocuments.net/reader035/viewer/2022070323/56649e205503460f94b0bf81/html5/thumbnails/4.jpg)
CBR Implementation
…Through the ACTIVE involvement in decision-making of Disabled persons, Their families and communities
With SUPPORT from appropriate health, education, vocational (Labour) and social services
Involving cross sector alliances and partnerships (WHO, Nov, 2004)
![Page 5: Associate Prof Theresa Lorenzo School of Health and Rehabilitation Sciences University of Cape Town](https://reader035.vdocuments.net/reader035/viewer/2022070323/56649e205503460f94b0bf81/html5/thumbnails/5.jpg)
EQUAL OPPORTUNITIES
“The process through which the various systems of society and the environment, such as services, activities, information and documentation are made available to all.”
UN World Programme of Action, 1982
![Page 6: Associate Prof Theresa Lorenzo School of Health and Rehabilitation Sciences University of Cape Town](https://reader035.vdocuments.net/reader035/viewer/2022070323/56649e205503460f94b0bf81/html5/thumbnails/6.jpg)
History Of CBR Training In South Africa Linked to Primary Health Care – promotion,
prevention and rehabilitative services (Declaration of Alma Ata)
Three pilot sites: late 1980s – SACLA Health Project, Khayelitsha; 6 months followed by in-service training
Early 1990s–IUPHC, Alexandra & Wits-Tintswalo CORRE Project, Acornhoek
Two years of alternating theory and practical work
![Page 7: Associate Prof Theresa Lorenzo School of Health and Rehabilitation Sciences University of Cape Town](https://reader035.vdocuments.net/reader035/viewer/2022070323/56649e205503460f94b0bf81/html5/thumbnails/7.jpg)
CBR Training Registered with HPCSA Board of
Occupational Therapy and Orthotics
Initially no formalised supervision
Later, supervisors’ workshops run in conjunction with CBR training
IUPHC training taken over by CREATE in 1999 till 2006
![Page 8: Associate Prof Theresa Lorenzo School of Health and Rehabilitation Sciences University of Cape Town](https://reader035.vdocuments.net/reader035/viewer/2022070323/56649e205503460f94b0bf81/html5/thumbnails/8.jpg)
Who has been trained and By Who? Parents of disabled
children
Disabled people Family members or
neighbours
Community members
OTTs
Rehab therapists
Social workers
Doctors
Disabled people and parents of disabled children
Accreditation – Diploma by Wits
![Page 9: Associate Prof Theresa Lorenzo School of Health and Rehabilitation Sciences University of Cape Town](https://reader035.vdocuments.net/reader035/viewer/2022070323/56649e205503460f94b0bf81/html5/thumbnails/9.jpg)
Content of TrainingRemoval of Barriers at an Individual Levels PHC and Prevention of Impairments
Physical impairments – cerebral palsy, stroke, spinal cord injuries, burns amputations, epilepsy
Mental impairments – learning difficulties and mental illness
Sensory impairments – speech, hearing and sight
Provision of assistive devices and equipment
![Page 10: Associate Prof Theresa Lorenzo School of Health and Rehabilitation Sciences University of Cape Town](https://reader035.vdocuments.net/reader035/viewer/2022070323/56649e205503460f94b0bf81/html5/thumbnails/10.jpg)
Content of Training (2)
Removal of Barriers at a Societal Level Health promotion
Disability awareness, advocacy and lobbying
Economic empowerment and employment
Project management
![Page 11: Associate Prof Theresa Lorenzo School of Health and Rehabilitation Sciences University of Cape Town](https://reader035.vdocuments.net/reader035/viewer/2022070323/56649e205503460f94b0bf81/html5/thumbnails/11.jpg)
Essential Achievements Increased access to information and support
in same language and culture
Increased access to health and social services, education and labour
Poverty alleviation – equal opportunities and social inclusion
Greater coverage of disabled children and adults for assistive devices
![Page 12: Associate Prof Theresa Lorenzo School of Health and Rehabilitation Sciences University of Cape Town](https://reader035.vdocuments.net/reader035/viewer/2022070323/56649e205503460f94b0bf81/html5/thumbnails/12.jpg)
Essential Challenges CBR is more than just an extension of
therapeutic services or
Overcome perception of CRWs giving a second rate service
CRWs are not recognised because of professional protectionism
Inaccessible transport is huge barrier
![Page 13: Associate Prof Theresa Lorenzo School of Health and Rehabilitation Sciences University of Cape Town](https://reader035.vdocuments.net/reader035/viewer/2022070323/56649e205503460f94b0bf81/html5/thumbnails/13.jpg)
Lessons Learnt Services should be needs-driven and not
professions-driven.
CRWs are change agents who deserve recognition.
Career pathway development of CRWs, with specific focus on capacity development for management and leadership positions, is long overdue.
![Page 14: Associate Prof Theresa Lorenzo School of Health and Rehabilitation Sciences University of Cape Town](https://reader035.vdocuments.net/reader035/viewer/2022070323/56649e205503460f94b0bf81/html5/thumbnails/14.jpg)
Lessons Learnt (2) White Paper on An Integrated National
Disability Strategy necessitates national ministries to listen and budget for integration of disability issues at all levels of governance and policy implementation.
But we need to mobilise communities to lobby and advocate for this to happen at local level.
![Page 15: Associate Prof Theresa Lorenzo School of Health and Rehabilitation Sciences University of Cape Town](https://reader035.vdocuments.net/reader035/viewer/2022070323/56649e205503460f94b0bf81/html5/thumbnails/15.jpg)
![Page 16: Associate Prof Theresa Lorenzo School of Health and Rehabilitation Sciences University of Cape Town](https://reader035.vdocuments.net/reader035/viewer/2022070323/56649e205503460f94b0bf81/html5/thumbnails/16.jpg)
INDS: Policy Guidelines Prevention Public education and
awareness raising Health Care Rehabilitation Barrier-free Access Transport Communications Data, information +
research
Education Employment Human resource
development Social Welfare +
community dev. Social security Housing Sports and
recreation
![Page 17: Associate Prof Theresa Lorenzo School of Health and Rehabilitation Sciences University of Cape Town](https://reader035.vdocuments.net/reader035/viewer/2022070323/56649e205503460f94b0bf81/html5/thumbnails/17.jpg)
Principles of CBR (WHO, 2004)
Inclusion
Participation
Sustainability
Empowerment
Self-advocacy
![Page 18: Associate Prof Theresa Lorenzo School of Health and Rehabilitation Sciences University of Cape Town](https://reader035.vdocuments.net/reader035/viewer/2022070323/56649e205503460f94b0bf81/html5/thumbnails/18.jpg)
Relevant Disability PoliciesInternational National
World Programme of Action (UN, 1992)
Standard Rules on Equalization of Opportunities for Persons with Disabilities (UN, 1993)
Community based Rehabilitation (WHO, 1994; WHO/ILO/UNESCO, 2004)
Convention on Rights of Persons with Disabilities (UN, 2006)
A White Paper on the Integrated national Disability Strategy (ODP, 1997)
National Rehabilitation Policies (DOH, 2000)
White Paper 6 on Inclusive Education
Employment Equity Act Skills Development Act
![Page 19: Associate Prof Theresa Lorenzo School of Health and Rehabilitation Sciences University of Cape Town](https://reader035.vdocuments.net/reader035/viewer/2022070323/56649e205503460f94b0bf81/html5/thumbnails/19.jpg)
UN Convention on Rights of Persons with Disabilities (UN, 2006) 48 Articles
Ratified by South Africa in 2007
Monitoring reports by government in 2010
Alternate reports by civil society organisations
![Page 20: Associate Prof Theresa Lorenzo School of Health and Rehabilitation Sciences University of Cape Town](https://reader035.vdocuments.net/reader035/viewer/2022070323/56649e205503460f94b0bf81/html5/thumbnails/20.jpg)
UNCRPD Principles Respect for inherent dignity, individual autonomy
including the freedom to make one’s own choices, and independence of persons
Non-discrimination Full and effective participation and inclusion in
society Equality of opportunity Accessibility Equality between men and women Respect for evolving capacities of children with
disabilities and respect for the right of children with disabilities to preserve their identities
![Page 21: Associate Prof Theresa Lorenzo School of Health and Rehabilitation Sciences University of Cape Town](https://reader035.vdocuments.net/reader035/viewer/2022070323/56649e205503460f94b0bf81/html5/thumbnails/21.jpg)
UN World Programme of Action (UN, 1992) Relationship between the disabled person,
the environment and their participation
Focus of WPA
Prevention Rehabilitation
Equalization of opportunities Needs + Rights
![Page 22: Associate Prof Theresa Lorenzo School of Health and Rehabilitation Sciences University of Cape Town](https://reader035.vdocuments.net/reader035/viewer/2022070323/56649e205503460f94b0bf81/html5/thumbnails/22.jpg)
Legislation
Capacity Building
Policy Development
By looking
at:
Strategies
![Page 23: Associate Prof Theresa Lorenzo School of Health and Rehabilitation Sciences University of Cape Town](https://reader035.vdocuments.net/reader035/viewer/2022070323/56649e205503460f94b0bf81/html5/thumbnails/23.jpg)
United Nations Standard Rules of Equalization Opportunities For Persons With Disabilities, 1993.
Address development needs of disabled peopleDual Approach Need for Individual Support
Need for Barrier-Free Environment
GOAL Integration on all levels
![Page 24: Associate Prof Theresa Lorenzo School of Health and Rehabilitation Sciences University of Cape Town](https://reader035.vdocuments.net/reader035/viewer/2022070323/56649e205503460f94b0bf81/html5/thumbnails/24.jpg)
4 Preconditions for Participation
Awareness – raising
Medical Care (health)
Rehabilitation
Support Services (assistive devices and technology)
![Page 25: Associate Prof Theresa Lorenzo School of Health and Rehabilitation Sciences University of Cape Town](https://reader035.vdocuments.net/reader035/viewer/2022070323/56649e205503460f94b0bf81/html5/thumbnails/25.jpg)
8 Target Areas for Participation
Accessibility – physical environment, information and transport etc.
Education – early childhood development, primary, secondary and tertiary.
Employment – open labour market, self employment, SMME
Social Security and Income Maintenance
![Page 26: Associate Prof Theresa Lorenzo School of Health and Rehabilitation Sciences University of Cape Town](https://reader035.vdocuments.net/reader035/viewer/2022070323/56649e205503460f94b0bf81/html5/thumbnails/26.jpg)
Target areas for participation (cont.)
Family Life and Personal Integrity
Culture (Arts, Cinema, Libraries, Music, Performances)
Recreation and Sports
Religion
![Page 27: Associate Prof Theresa Lorenzo School of Health and Rehabilitation Sciences University of Cape Town](https://reader035.vdocuments.net/reader035/viewer/2022070323/56649e205503460f94b0bf81/html5/thumbnails/27.jpg)
10 Implementing Measures
Information and Research
Policy Making and Planning
Legislation Economic Policies Co-Ordination Of
Work
Organizations Of Disabled People
Personnel Training National Monitoring
and Evaluation of Disability Programmes
Technical and Economic Co-Operation
International Co-Operation
![Page 28: Associate Prof Theresa Lorenzo School of Health and Rehabilitation Sciences University of Cape Town](https://reader035.vdocuments.net/reader035/viewer/2022070323/56649e205503460f94b0bf81/html5/thumbnails/28.jpg)
INDS VISION
A Society for all
Integration/ InclusionHuman RightsEqual Opportunities
Vulnerable groups
Effective service delivery infrastructure
![Page 29: Associate Prof Theresa Lorenzo School of Health and Rehabilitation Sciences University of Cape Town](https://reader035.vdocuments.net/reader035/viewer/2022070323/56649e205503460f94b0bf81/html5/thumbnails/29.jpg)
INDS: PRINCIPLES
People driven/ Self-representation
Democratization = Participation
Integration and sustainability
![Page 30: Associate Prof Theresa Lorenzo School of Health and Rehabilitation Sciences University of Cape Town](https://reader035.vdocuments.net/reader035/viewer/2022070323/56649e205503460f94b0bf81/html5/thumbnails/30.jpg)
Vulnerable groups
Vulnerable groups
People with AIDS
Refugees + displaced people
Remote Rural
People with multiple disabilities
YouthElderly
People with severe intellectual disabilities or mental illness
Children Women
![Page 31: Associate Prof Theresa Lorenzo School of Health and Rehabilitation Sciences University of Cape Town](https://reader035.vdocuments.net/reader035/viewer/2022070323/56649e205503460f94b0bf81/html5/thumbnails/31.jpg)
INDS: OBJECTIVES
Facilitate integration of disability issues into govt. developmental strategies, planning and programmes.
Develop integrated management system for co-ordination of line functions and tiers of government.
Develop capacity building strategies for implementation of INDS by all levels.
![Page 32: Associate Prof Theresa Lorenzo School of Health and Rehabilitation Sciences University of Cape Town](https://reader035.vdocuments.net/reader035/viewer/2022070323/56649e205503460f94b0bf81/html5/thumbnails/32.jpg)
Nelson Mandela
![Page 33: Associate Prof Theresa Lorenzo School of Health and Rehabilitation Sciences University of Cape Town](https://reader035.vdocuments.net/reader035/viewer/2022070323/56649e205503460f94b0bf81/html5/thumbnails/33.jpg)
CBR reworded
Community based disability support (CBDS) is a strategy within general community development for the equalisation of opportunities for disabled people and their families…
Through the combined efforts of disabled people organisations, government, civil society and business