CBR
Karen Castro
Created on February 18, 2022
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CBRKaren Castro Medina
Community based Rehabilitation
(CRPD, 2006)
01
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Convention on the Rights of Persons with Disabilities, which states that disability is an evolving concept and “results from the interaction between persons with impair- ments and attitudinal and environmental barriers that hinders their full and effective participation in society on an equal basis with others”
(CBR Guidelines)
01
HUMAN RIGHTS
Human rights are internationally agreed standards which apply to all human beings (22); everybody is equally entitled to their human rights – e.g. the right to education and the right to adequate food, housing and social security – regardless of nationality, place of residence, sex, national or ethnic origin, colour, religion, or other status.
01
Community-based rehabilitation (CBR) was first initiated by the World Health Organization (WHO) following the International Conference on Primary Health Care in 1978 and the resulting Declaration of Alma-Ata. CBR was seen as a strategy to improve access to rehabilitation services for people with disabilities in developing countries.
Background
02
Following the Alma-Ata declaration, WHO introduced CBR. In the beginning CBR was primarily a service delivery method making optimum use of primary health care andcommunity resources, and was aimed at bringing primary health care and rehabilitation services closer to people with disabilities, especially in low-income countries. Ministries of health in many countries (e.g. Islamic Republic of Iran, Mongolia, South Africa, Viet Nam) started CBR programmes using their primary health care personnel. Early programmes were mainly focused on physiotherapy, assistive devices, and medical or surgical interventions. Some also introduced education activities and livelihood opportunities through skills-training or income-generating programmes.
Background
In May 2003, WHO in partnership with other UN organizations, governments and international nongovernmental organizations including professional organizations and disabled people’s organizations, held an international consultation in Helsinki, Finland, to review CBR. The report that followed highlighted the need for CBR programmes to focus on:
- reducing poverty, given that poverty is a key determinant and outcome of disability;
- promoting community involvement and ownership;
- developing and strengthening of multisectoral collaboration;
- involving disabled people’s organizations in their programmes;
- scaling up their programmes;
- promoting evidenced-based practice.
Background
The first four components relate to key development sectors, reflecting the multisectoral focus of CBR. The final component relates to the empowerment of people with disabilities, their families and communities, which is fundamental for ensuring access to each development sector and improving the quality of life and enjoyment of human rights for people with disabilities.
CBR programmes are not expected to implement every component and element of the CBR matrix. Instead the matrix has been designed to allow programmes to select options which best meet their local needs, priorities and resources. In addition to implementing specific activities for people with disabilities, CBR programmes will need to develop partnerships and alliances with other sectors not covered by CBR programmes to ensure that people with disabilities and their family members are able to access the benefits of these sectors.
Vídeo
The CBR principles are based on the principles of the Convention on the Rights of Persons with Disabilities. In addition, two further principles have been proposed which are: empowerment including self-advocacy, and sustainability. These principles should be used to guide all aspects of CBR work.
01
CBR PRINCIPLES
a. Respect for inherent dignity, individual autonomy including the freedom to make one’s own choices, and independence of persons.b. Non-discrimination.c. Full and effective participation and inclusion in society.d. Respect for difference and acceptance of persons with disabilities as part of human diversity and humanitye. Equality of opportunity.f. Accessibility g. Equality between men and women.h. Respect for the evolving capacities of children with disabilities and respect for the right of children with disabilities to preserve their identities.
Principles
EvaluationStage 4
Implementation and monitoring Stage 3
Planing an designStage 2
Situation analysis Stage 1
While all CBR programmes are different, there is a universal sequence of stages that help to guide their development. These stages are usually collectively referred to as the management cycle, and comprise:
Management
01
Roleplay
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Implementation of CBR program
For example, information could be collected about
A situation analysis aims to answer the following question: “Where are we now?” It helps planners to build up an understanding of the situation (or context) in which people with disabilities and their families live, to determine the most appropriate course of action.
Population, living condition, health, education, economics, goverment, culture, religion, geography and climate
Stage 1Situation analysis
Lack of participation Lack of accessPoverty No referal system
Problem of mobility of PwD
Steps involved
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Planners should begin this stage with a clear picture of the situation of people with disabilities and the context in which the CBR programme will operate; they should have information about the number of people with disabilities, the needs of people with disabilities and their families, possible solutions to problems, and the availability of communityresources.
Plan together with the stakeholders, set priorities, prepare a program plan (activities, indicators, sources of verification), decided what resources are needed, prepare a budget
Stage 2Planning and design
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The third stage, Implementation and monitoring, involves putting the plans from Stage 2 into action, and ensuring that all necessary activities are carried out as scheduled and are producing the required outcomes. During the implementation stage, it is important to continuously monitor the progress of the CBR programme. Monitoring provides information for managers so that they can make decisions and changes to short-term planning to ensure that outcomes are met and that, eventually, the goal and purpose are achieved.
Develop detailed workplans, mobilize and manage resources, carry out planned activities, setting indicators, collecting and recordinf information, analysing information, managing information.
Stage 3Implementation and monitoring
Steps
The final stage of the management cycle, involves an assessment of the current or completed CBR programme. It helps determine whether the outcomes outlined in the programme plan have been met andhow the situation on which they were based has changed. Evaluation can lead to a decision to continue, change or stop a programme, and can also provide important evidence that CBR is a good strategy for equalization of opportunities, poverty reduction and social inclusion of people with disabilities.
Focus the evaluation, collect information, analyse the information and draw conclusions, share findings and take action.
Stage 4Evaluation
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