Introduction to community-based rehabilitation (CBR)

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Contents

• Definition

• What is CBR?

• What do CBR programs have in common?

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Definition

“Community-based rehabilitation (CBR) is a strategy within community development

for the rehabilitation, equalization of opportunities, poverty reduction and

social inclusion of all people with disabilities. CBR is implemented through the combined efforts of disabled people

themselves, their families and communities, and the appropriate health, education, vocational and social services.”

(ILO, UNESCO & WHO, 2004)

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What is CBR?

CBR is a primary health care initiative and comprehensive social model for addressing rehabilitation care in a community setting.

It emphasizes community participation, empowering the community to direct their own rehabilitation care, reinforcing human

rights of persons with disabilities, and using existing community resources

(Sharma, 2004).

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What is CBR?

CBR extends the biomedical model of disability to incorporate social concerns, such as the exclusion of persons with disabilities from

mainstream education and discrimination in health services. Its development has been

driven by participation from stakeholders in disability activism and persons with

disabilities (Hartley, Finkenflügel, Kuipers, & Thomas, 2009).

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What is CBR?

The new understanding of CBR can be represented by the CBR matrix which

includes 5 major dimensions of rehabilitation: health, education, livelihood,

social, and empowerment (ILO,

UNESCO & WHO, 2010).

What is CBR?

CBR emphasizes the use of mainstream, existing resources, such as health facilities, educational institutions, community services, and non-governmental organizations (ILO, UNESCO & WHO, 2010).

What do CBR programs have in common?

• Although CBR programs vary, common elements of sustainable programs include:– National level support in coordinating

resources and policies– A human rights-based approach– Voluntary participation from the community– Motivated community health workers

(ILO, UNESCO & WHO, 2004)

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What do CBR programs have in common?

Intended outcomes from CBR:• Individual and community knowledge of disabilities

increases• The community is involved in their own rehabilitation

care, and rehabilitation is delivered with collaboration from various sectors of society

• Discrimination on the basis of disability and other factors (eg. gender) in the health sector is reduced

• Access to rehabilitation services is improved • Persons with disabilities more actively participate in

education, work, and community life

(ILO, UNESCO & WHO, 2010)

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References

• Hartley, S., Finkenflügel, H., Kuipers, P., & Thomas, M. (2009). Community-based rehabilitation: Opportunity and challenge. Lancet, 374(9704), 1803-1804.

• ILO, UNESCO & WHO (2004). Community-based rehabilitation for and with people with disabilities. Joint Position Paper. Geneva: UN.

• ILO, UNESCO & WHO (2010). Introductory booklet - Community-based rehabilitation - CBR guidelines. Geneva: UN.

• Sharma, M. (2004). Viable methods for evaluation of community-based rehabilitation programs. Disability and Rehabilitation, 26(6), 326-334.

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