28 - Community-Based Rehabilitation

Abstract

Community-based rehabilitation (CBR) is a strategy that promotes collaboration among people with disabilities and their families, government and nongovernment stakeholders to promote an inclusive society that provides equal opportunities for all. Originally designed as a means of addressing the rehabilitation needs of people with disabilities in low- or middle-income countries, the strategy has evolved from a medically framed service delivery model to a community development approach grounded in human rights, empowerment, ownership and sustainability of a disability-inclusive community. Despite this conceptual evolution, in practice many CBR programmes continue with a traditional rehabilitation emphasis. The World Federation of Occupational Therapists recognises the coherence of CBR and occupational therapy approaches, promoting CBR as a means of facilitating access to occupation for all (World Federation of Occupational Therapists (WFOT), 2004b). There are shared beliefs in, for example, the importance of activity, participation, collaboration, and the environment. Occupational therapists are well positioned to contribute to the realisation of quality CBR initiatives in many ways. This may include, for example, working with people experiencing illness, injury or impairment and their families to identify and achieve their desired goals, provide direct therapy, and transfer of knowledge to other stakeholders. Importantly occupational therapists can act as facilitators by ensuring people experiencing illness, injury or impairment are key decision makers in their own lives and communities, as well as contributors to advocacy, policy, design and evaluation of CBR.