Principles of CBR, Difference between IBR & CBR

The presentation describes the principles, difference b/w IBR and CBR. Members of the CBR team

1. CHAPTER 3 Nischitha R Rao

2. Table of Contents Introduction Definition Concept of CBR Need for CBR Difference between CBR & IBR Objectives & Scope of CBR Members of CBR team Models of CBR

3. Introduction Community-based rehabilitation (CBR) was initiated by WHO following the Declaration of Alma-Ata in 1978 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. While initially a strategy to increase access to rehabilitation services in resource-constrained settings.

4. CBR is now a multisectoral approach working to improve the equalization of opportunities and social inclusion of people with disabilities while combating the perpetual cycle of poverty and disability. 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.

5. UNESCO and WHO define CBR, as A strategy within community development for rehabilitation, equalization of opportunities, and social inclusion for all children and adults with disabilities.

6. CBR is implemented through the combined efforts of people with disabilities themselves, their families and communities, and appropriate health, education, vocation and social services.

7. Concept of CBR Disability and Rehabilitation Human Rights Poverty Inclusive Communities Organizations of Persons with Disabilities (DPOs)

8. Need for CBR Training family and community members on disability and CBR using the WHO CBR training manual as a guide; Providing educational assistance and facilitating inclusive education through capacity building with teaching staff and students, and improving physical access; Referring people with disabilities to specialist services, e.g. surgical and rehabilitation services, where physiotherapists, speech therapists and occupational therapists are available;

9. Providing assistive devices, e.g. walking sticks, crutches, wheelchairs, hearing aids, glasses; Creating employment opportunities by providing access to training, job coaching and financial support for income-generation activities; Providing support for social activities including for sports and recreation; Providing financial assistance for living, education and home modifications.

10. Objectives & Scope of CBR The major objectives of CBR are: To ensure that people with disabilities are able to maximise their physical and mental abilities, to access regular services and opportunities, and to become active contributors to the community and society at large.

11. To activate communities to promote and protect the human rights of people with disabilities through changes within the community, for example, by removing barriers to participation.

12. Difference between IBR & CBR CBR IBR Flexible Rigid or a blue-print Active involvement of families and communities An approach which only focuses on the physical or medical needs of a person A partnership approach with disabled people and parents of disabled children Long-term residential care Capacity building of disabled people and their families, in the context of their community and culture Delivering a service to disabled people as passive recipients Holistic in its approach to disabled people; addressing social, employment, educational, and other needs not just physical multi- sectoral Only outreach from a centre An approach which uses centres/institutions to respond to the needs of disabled people and their families Rehabilitation training in isolation An approach which aims to enable around 80% of disabled people’s rehabilitation needs to be addressed in the community Surveys on disability with no Action Integrated into existing services and promoting the social inclusion of disabled people Long term strategy Limited to one sector Short term strategy

13. Members of CBR Team

14. Rehabilitation approaches and Strategies Community based rehabilitation Institutional based rehabilitation Outreach services

15. Out Reach Program Here the expert from hospital visit the community or home for disabled. And training will be given in the areas of; -self care -ambulatory effect -vocational guidance

16. Models of CBR Biomedical Model Social Model The problem is individual centred The problem is society centred       Ownership of rehabilitation is in the institutions, the professionals   Ownership of rehabilitation is in the community We seek a «  normalization  » of the people with disability We seek an inclusion of the people with disability by the adaptation of the society

17. Models Structure Human Resources Origin Medical Institution Professional National / Regional government Educational Outreach Semi- Professional Non –government – international/national/regional Economic Network Non- Professionals (Volunteers, PWD, Community) Multisectoral -international/regional/national Vocational Non-service Semi- Professional/ Non- Professionals Individuals – grassroots persons with disabilities etc. Comprehensive Biopsychosocial model McColl and Paterson , 1995 & WHO 2000

18. Medical model of rehabilitation This model is followed by institutes (Institutional based rehabilitation). Service providers only concentrate on medical problems.

19. Medical and social model Community and persons with disabilities are major resource. More democratic Person with disability are major decision maker. Rehabilitation takes place at the door step of the patient with disability. This model include early intervention, regular follow up, and total rehabilitation

20. Principles of CBR 1.Inclusion 2.Participation 3.Empowerment 4.Self advocacy 5.Fascilitation 6.Gender sensitivity and special needs 7.Partenership 8.Sustainability UNICEF : Joint Position Paper,2004

21. CBR Matrix