Community Based Rehabilitation (CBR).pptx

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1. Community Based Rehabilitation (CBR)

2. Introduction Community Based Rehabilitation is a community development strategy that aims at enhancing the lives of persons with disabilities(PWDs)within their community. CBR is a strategy that focuses on providing equal opportunities to persons with disabilities so they can participate in community life  Community-based rehabilitation (CBR) was initiated by WHO in an effort to enhance the quality of life for people with disabilities and their families; meet their basic needs; and ensure their inclusion and participation.

3. Introduction cont …. While initially a strategy to increase access to rehabilitation services in resource-constrained settings, CBR is now a multi-sectoral approach working to improve the equalization of opportunities and social inclusion of people with disabilities while combating the perpetual cycle of poverty and disability.

4. Introduction cont …. CBR is implemented through the combined efforts of people with disabilities, their families and communities, and relevant government and non-government health, education, vocational, social and other services(WHO). It emphasizes utilization of locally available resources including beneficiaries, the families of PWDs and the community.

5. Introduction cont …. According to the UN Convention on the Rights of Persons with Disabilities, comprehensive rehabilitation services focusing on health, employment, education and social services are needed to enable PWDs/CWDs attain and maintain maximum independence, full physical, mental, social and vocational ability, and full inclusion and participation in all aspects of life (UN, 2006)

6. Rehabilitation Rehabilitation is relevant to people experiencing disability from a broad range of health conditions and therefore the CRPD makes reference to both “ habilitation ” and “ rehabilitation ”. Habilitation aims to assist those individuals who acquire disabilities congenitally or in early childhood and have not had the opportunity to learn how to function without them. Rehabilitation aims to assist those who experience a loss in function as a result of disease or injury and need to relearn how to perform daily activities to regain maximal function. Habilitation is a newer term and is not commonly used in low-income countries, therefore the term rehabilitation is commonly used “” to refer to both habilitation and rehabilitation

7. Introduction cont ….

8. The strategies of Community Based Rehabilitation The strategies of community based rehabilitation include : National level support through policies, co-ordination and resource allocation. Recognition of the need for CBR programmes to be based on a human rights approach. The willingness of the community to respond to the needs of their members with disabilities. The presence of motivated community workers

9. Role or functions of CBR Promote rehabilitation service or activities to community level Support and implement service or activities to community level Facilitate referrals to access more specialized rehabilitation services Encourage function independent to PWDs Provide early intervention activities for child development

10. Role or functions of CBR ●  It helps to make rehabilitation services more available. The WHO estimates that 30 million people in Africa, Asia, and Latin America require approximately 180,000 rehabilitation professionals. In the absence of professionals, however, we can meet many of the needs of persons with disabilities locally without referral to specialized, expensive services. For example, we can train local CBR volunteers to provide support and basic therapy. Additionally, we can advocate for local health services to actively include persons with disabilities.

11. Role or functions of CBR ●  It promotes culturally appropriate services. Local people understand the cultural context and are able to challenge stereotypes in a non-threatening manner. ●  It brings value to community life. By enabling communities to respond to persons with disabilities in their midst, CBR promotes acceptance of all, allows everyone to contribute to society, and helps communities to become more sensitive and interdependent.

12. Role or functions of CBR ●  It puts into practice the CBR ‘philosophy of care’. Many disability services follow a purely medical approach to disability, i.e. people are viewed in terms of their impairment or difficulty, whereas CBR has a holistic approach that sees a person in their social context and treats persons with disabilities with full dignity . CBR brings about a paradigm shift whereby persons with disabilities are seen as more than just their impairment. It is important to note that CBR is not the only approach to provision of disability services. For example, Centre-based disability programmes are another valid approach and can work in conjunction with CBR. However, they tend to require more resources and expertise

13. Principles of CBR Respect for inherent dignity and individual autonomy. Non-discrimination . Full and effective participation and inclusion in society. Respect for difference and acceptance of persons with disabilities as part of human diversity and humanity. Equality of opportunity. Accessibility . Equality between men and women. Respect for the evolving capacities of children with disabilities Respect for the right of children with disabilities to preserve their identity

14. Challenges of CBR Unavailability of resources Care giver’s poor health Lack of training and education Lack of fund Poor infrastructure Cultural believes

15. Institutional based rehabilitation(IBR) Institutional based rehabilitation sets the policy and directions with care standards of homes for children and young persons with rehab or disability-related cases. The care framework in the rehabilitation aims to guide and support the patients at every step, from the homes to their re-entry into the society. Rehabilitation is acknowledged as an opportunity when self-care, family support arrangement, and community options are not enough.

16. Institutional based rehabilitation(IBR) The  role of rehabilitation  is viewed as a significant help for a person to improve his overall mental and emotional behavior . It offers intervention programs which follow an institution based rehab that aims to equip the person with life skills and knowledge to handle personal issues . It is the institution’s goal to help the patient to function in everyday life

17. Institutional Rehabilitation Programs This program primarily focuses on essential factors such as therapy, holistic education, personal mastery of habits and self–discipline. In the therapeutic program, the service motivates the patient to rethink everything, assess reasoning, react to sessions and manage relationship building. For the education program, the service provides sessions for restoring self-belief and strengthening the foundation for future learning. The personal mastery of habit focuses on strength and weaknesses. It broadens horizon, adapts to skills, and explore opportunities. And self-discipline manages to evaluate the person’s overall capability to adjust to stressful situations

18. CBR vs IBR   Institution-based rehabilitation:  In Institution-based rehabilitation, the Focus of control is based in the institution.  This  service meets a small number of needs of a small number  of disabled people. This is at best a limited approach, and at worst it can abuse the rights of disabled  persons. 2 . Community Based Rehabilitation:  With CBR, the locus of control should be with the community . So the starting point is exactly the opposite. The disabled people, family and community members decide what their priorities are, and then work together with local organizations , government, institutions, in order to access the relevant and appropriate services . The difference is that they respond to needs rather than dictate them

19. CBR vs IBR FACTOR CBR IBR Man power Volunteers Employed Structure Temporary Fixed Cost of treatment Cheaper Costly Accessibility of services Accessible to all Accessible to only few Social rehabilitation Possible Not possible as patient is away from family Extension of service Can be done without much cost Not possible Application of advanced technique Not possible Possible

20. FACTOR CBR IBR Social economic status Considered Not Considered Promotion of awareness yes Not Community interaction Done Minimal Evaluation Difficult Possible Skilled personal care Not given Given Psychological rehabilitation Much possible as they have support of the family Not much possible

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