Abstract
BackgroundThis paper presents the methodology and findings from a proof-of-concept study undertaken to explore the viability of conducting a systematic, largely qualitative synthesis of evaluation reports emanating from Community Based Rehabilitation (CBR) projects in developing countries.MethodsComputer assisted thematic qualitative analysis was conducted on recommendation sections from 37 evaluation reports, arising from 36 disability and development projects in 22 countries. Quantitative overviews and qualitative summaries of the data were developed.ResultsThe methodology was found to be feasible and productive. Fifty-one themes were identified and the most important ones of these are presented to illustrate the significance of the method. The relative priorities of these themes indicated that "management" issues were the primary areas in which recommendations were made. Further analysis of themes reflected the emphasis evaluators placed on the need for enhanced management, organisational, personnel and administrative infrastructure in CBR projects. Evaluators consistently recommended that CBR projects should be more connected and collaborative at governmental, organisational, political and community levels. The synthesis also noted that evaluators questioned the emphasis in CBR on project expansion and income generation.ConclusionThe application of the synthesis methodology utilised in this proof-of-concept study was found to be potentially very beneficial for future research in CBR, and indeed in any area within health services or international development in which evaluation reports rather than formal "research evidence" is the primary source material. The proof-of-concept study identified a number of limitations which are outlined. Based on the conclusions of 37 evaluation reports, future policy frameworks and implementation strategies in CBR should include a stronger emphasis on technical, organisational, administrative and personnel aspects of management and strategic leadership.
Highlights
This paper presents the methodology and findings from a proof-of-concept study undertaken to explore the viability of conducting a systematic, largely qualitative synthesis of evaluation reports emanating from Community Based Rehabilitation (CBR) projects in developing countries
This study has striven to suggest a new approach to data synthesis and evidence in CBR
The methodology was found to be practical, achievable and reliable. It has revealed some important implications in relation to policy and planning of CBR programmes
Summary
This paper presents the methodology and findings from a proof-of-concept study undertaken to explore the viability of conducting a systematic, largely qualitative synthesis of evaluation reports emanating from Community Based Rehabilitation (CBR) projects in developing countries. Research and publication within the area of disability and development, and that pertaining to community based rehabilitation (CBR) service delivery, has primarily been descriptive in nature. While this has led to considerable advances in understanding processes and issues, it has not resulted in clear policy, evidence of efficacy, or practice directives. [1], identified that, Governments want evidence-based practices, so CBR programmes must be ready to provide evidence (p15). With the exception of a recent detailed review [2], and some specific reviews [3], there are few studies in CBR which might be used to contribute to such an evidence base within traditional approaches to determining evidence. Pope & Popay [6] have challenged researchers to develop appropriate methodologies to accommodate and maximize these wide ranging and disparate types of evidence
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