Abstract
Community based rehabilitation (CBR) has evolved over the last 30 years and now focuses on empowering persons with disabilities to access and benefit from a wide range of services. The essence and ethos of CBR is captured in several global frameworks, such as the UN Convention on the Rights of People with Disabilities (2006) and the CBR guidelines (2010). The latter contains the CBR matrix. All 15 countries in southern Africa are implementing CBR mostly in rural areas, but the policy framework to guide CBR in the region is unknown. The purpose of the study was to determine to what extent countries in southern Africa have adapted the global frameworks available for CBR. A CBR policy analysis using proof-of-concept methodology was undertaken. Policy documents on CBR were sought from relevant government departments or agencies. Multiple methods and media, including web searches, searches for grey literature, social media and contact through an elaborate network of colleagues working in the region, were employed to execute the search strategy. Data were organized using NVivo software, and three independent raters coded the emergent themes using the CBR matrix. Only Namibia, South Africa, Tanzania and Zimbabwe have specific policy content for CBR. These, however, lacked structure; the content was predominantly aligned to health. Inclusion of key international concepts such as mainstreaming and empowerment were superfluous when present. The CBR policy environment in southern Africa appears inadequate. Contingent factors that preclude adaptation of the global frameworks available for CBR appear to be at play. These warrant further investigation.
Highlights
Community based rehabilitation (CBR) has evolved over the last 30 years and focuses on empowering persons with disabilities to access and benefit from a wide range of services
With the exception of Botswana, Lesotho and Mauritius, all the other countries that did not have a CBR policy/guideline had the CBR program in that country administered by development agencies such as GTZ (Deutsche Gesellschaft fur Technische Zusammenarbeit GmbH, a German government agency involved in health development), nongovernmental organizations (NGOs) such as Cheshire Homes, the Leprosy Mission, various church organizations; or by organizations or individuals with an interest in the welfare of persons with disabilities
The findings of this study demonstrate that all the countries that had a CBR policy or guideline used English as one of the main languages for conducting business
Summary
Community based rehabilitation (CBR) has evolved over the last 30 years and focuses on empowering persons with disabilities to access and benefit from a wide range of services. The purpose of the study was to determine to what extent countries in southern Africa have adapted the global frameworks available for CBR. Contingent factors that preclude adaptation of the global frameworks available for CBR appear to be at play. Community based rehabilitation (CBR) was initiated in the mid-1980s by the WHO and over the years has evolved to become a multi-sectoral strategy that empowers persons with disabilities to access and benefit from a wide range of services. In order to achieve its goals, CBR calls for the full and coordinated involvement of all levels of society: community, intermediate and national[3,6,7]
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