Introduction:
According to estimates, about 15 percent of the world's population (or more than 1 billion people) have a disability, of which about 100 million are under 15 worldwide. Being the largest group of vulnerable people in society, these disabled people face various difficulties, including limited access to educational and employment opportunities, poor infrastructure support, negative views of healthcare professionals, and little support from family members, particularly in developing nations. In addition, ensuring the rehabilitation of the disabled, particularly in community settings, is of important public health concern due to the overwhelmed state of the public health care delivery system.
What Is Community-Based Rehabilitation?
Rehabilitation is the process of integrating and organizing medical, occupational, social, and psychological interventions to help people achieve optimal good health and social integration. Community-based rehabilitation (CBR) is a concept that was developed in 1978 to increase the accessibility of rehabilitation services for persons with disabilities, particularly in developing nations. Therefore, CBR entails various strategies that are put into practice in collaboration with numerous sectors to help disabled people or their family or community members irrespective of any criteria by raising awareness, eradicating stigma, supporting social inclusion, achieving basic needs, and providing access to health, education, and employment opportunities.
What Are the Scopes and Benefits?
People with disabilities are supported by community-based rehabilitation (CBR) programs, which put health services at their doorsteps and create a solid connection between them and the healthcare system.
The CBR program's main activities include setting up training events for the betterment of family and community members with disabilities, assisting with education and enhancing physical access, providing referral services, offering assistance (such as financial support and assistive devices), setting up employment opportunities, and expanding social and recreational asset.
Numerous research findings have demonstrated that CBR initiatives have benefited impaired people's social inclusion, mobility, and independence while being cost-effective. Additionally, they have increased educational and professional options and improved communication abilities.
What Are CBR Principles?
The CBR principles have their basis in the Committee on the Rights of Persons with Disabilities (CRPD) principles. The guidelines are:
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Respect for one's inherent worth and autonomy including their right to free will and independence from others.
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Non-discrimination.
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Full and effective societal inclusion and participation.
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Respect for diversity and inclusion of people with disabilities as a part of humanity.
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Opportunity equality.
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Accessibility.
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Equal rights for men and women.
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Respect for the rights of children with disabilities to maintain their identities and care for the abilities still developing in children with disabilities.
What Are the Challenges in the CBR Field?
The assessment studies have shown an extensive number of challenges in the practical application of CBR, including ambiguity surrounding the concept, unpredictability about how its implementation can be encouraged in the community, execution of a similar CBR framework without modifying it to the local settings, lack of any inbuilt process to ensure assessment of the strategy, and a host of other issues. These obstacles have gravely endangered the implementation and longevity of CBR programs.
Strong leadership is required to make it easier for theory to become practice to remove the hurdles that have been identified. To support this intervention, adequate cooperation amongst various stakeholders, including policymakers, doctors, nurses, community members, and non-governmental organizations, is also necessary.
What Are the Strategies to Overcome the Barriers?
Other interventions include establishing precise and unambiguous goals and objectives, developing a thorough CBR evaluation framework (done in close cooperation with the local community, including people with disabilities), and evaluating the framework to see if it is relevant and appropriate in the regional settings.
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Combining qualitative and quantitative approaches to assess the efficacy of this approach properly.
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Encouraging the use of monitoring and management information systems.
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Ensuring active community involvement through the creation of context- and culture-specific programming.
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The hiring of qualified individuals from adjacent industries who want to work to improve the lives of disabled people.
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Planning training sessions for CBR employees, ensuring sufficient resources are available, and providing referral services.
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Utilizing multidisciplinary teams to guarantee effective service delivery within the community.
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Arranging formal and informal meetings for the team members to improve coordination and cohesion.
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Developing tools to track their effectiveness and effects on health metrics.
What Is Primary Health Care and Rehabilitation?
Health is "a state of complete physical, mental, and social well-being and not just the absence of disease or infirmity." Primary health care is necessary healthcare that is universally accessible to all people and their families in the community using their full involvement and at a rate that the community and the nation can preserve at each phase of their growth in a manner of self-reliance and self-determination. Primary healthcare is based on feasible, scientifically accurate, and socially acceptable techniques and technology. It is crucial in the community's general social and economic development and the nation's health system. It is the first point of contact between people, families, and communities and the national health system, which aims to bring health care as close to people's homes and places of employment as possible. It also represents the first step in a continuous process of providing health care.
The idea of primary health care is completely consistent with community-based rehabilitation. This strategy encourages community members to be informed, self-sufficient, and responsible for rehabilitation. It draws on the community's human resources, including disabled individuals, their families, and others. CBR promotes adopting straightforward strategies and tactics that are accepted, inexpensive, efficient, and suitable for the local environment.
Conclusion:
Community-based rehabilitation involves a variety of interventions that are carried out for a complex and diverse population of disabled persons, necessitating meticulous planning and methodical execution to ensure the welfare of these vulnerable individuals. The fundamental idea underlying the multi-sectoral approach to CBR is the decentralization of power and resources, both human and financial, to community-level groups. In this strategy, community activities and groups must be supported by institutional and outreach services provided by both the public and private sectors.
