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Specific Emergency Conditions in Forced Displacement Settings
Published in Miriam Orcutt, Clare Shortall, Sarah Walpole, Aula Abbara, Sylvia Garry, Rita Issa, Alimuddin Zumla, Ibrahim Abubakar, Handbook of Refugee Health, 2021
Natalie Roberts, Halfdan Holger Knudsen, Alvin Sornum, Taha Al-Taei, Barbara Scoralick Villela, Maryam Omar, Faith Traeh, Abdulkarim Ekzayez, Clare Shortall, Eric Weerts
Strategies for tertiary prevention in low- and middle-income settings include WHO-endorsed community-based rehabilitation (CBR), which is a strategy for rehabilitation, poverty reduction, equalisation of opportunities and social inclusion of all people with disabilities.32 Initially the focus was on physiotherapy, assistive devices and medical interventions. However, it is now seen as a method of ensuring community-based inclusive development. There are five main components: health, education, livelihoods, social and empowerment. The health component of this normally involves the following elements: health promotion and primary prevention (inclusive of those with disabilities, ensuring there are no barriers to accessing healthcare through collaboration with local health services), rehabilitation (e.g. practising mobility exercises and adapting the physical environment) and provision of assistive devices (including locally available and affordable mobility devices). CBR has a bottom-up strategy with services being delivered within communities with mostly locally acquired resources all adding to the appropriateness and low cost of CBR interventions. CBR has been found to improve health outcomes and improve functioning and quality of life.
Assessing Individual Functioning and Disability
Published in Stefano Federici, Marcia J. Scherer, Assistive Technology Assessment Handbook, 2017
Stefano Federici, Marcia J. Scherer, Fabio Meloni, Fabrizio Corradi, Meera Adya, Deepti Samant, Michael Morris, Aldo Stella
Community-Based Rehabilitation (CBR) Models: CBR was conceptualized and promoted by the WHO and related UN agencies in the early 1980s as a method of providing services to people with disabilities in developing countries who had no access to quality rehabilitative facilities, physicians, and other qualified personnel. The original rationale behind CBR was to circumvent the need for expensive institutional care and a lack of government support by providing cost-effective rehabilitation services to people with disabilities within their own homes and communities. Although its inception focused on the need for medical rehabilitative care, it has evolved owing to a realization that rehabilitation aimed at promoting independent functioning has to respond to the need for securing equal rights and access to services such as education, employment, health services, and public services and facilities. As CBR works on the principle of finding solutions through locally available resources, most AT delivered through CBR programs is designed to be affordable, made with locally available materials, and appropriate to the environment of the consumer.
A Global Perspective on Neuropsychological Rehabilitation
Published in Barbara A. Wilson, Jill Winegardner, Caroline M. van Heugten, Tamara Ownsworth, Neuropsychological Rehabilitation, 2017
Jill Winegardner, Rudi Coetzer
Throughout most of the world neuropsychological rehabilitation, as understood in well-resourced countries, does not exist. Most people with injuries or illnesses affecting their brains have little or no access to basic education or support, let alone access to qualified therapeutic intervention or neuropsychological rehabilitation. WHO has developed an initiative called Community-Based Rehabilitation (CBR) to address this lack of rehabilitation for people with disabilities throughout the world. CBR is far more than a health initiative, as it not only addresses immediate health and rehabilitation needs but also takes the wider perspective that people with disabilities need not only health care but also relief from poverty, access to education, a means of livelihood and social inclusion and participation. CBR has evolved as a set of universal principles for promoting policies and legislation that aim to ensure that people with disabilities have truly equal opportunities to achieve a good quality of life and human rights.
Experiences accessing and using rehabilitation services for people with physical disabilities in Sierra Leone
Published in Disability and Rehabilitation, 2022
Justine Aenishänslin, Abu Amara, Lina Magnusson
Through addressing societal stigma and attitudinal barriers, health promotion can increase knowledge about the availability and utility of rehabilitation services, increasing their overall approachability and heightening support for the access and use of rehabilitation services. The WHO has long recommended community-based rehabilitation (CBR) to improve quality of life, participation and empowerment of persons with disability [52]. However, in Sierra Leone, Trani et al. [53] found that in existing CBR programs there was higher engagement from non-disabled persons than those with disabilities. Further research on how to effectively engage both the wider community and persons with physical disabilities through community engagement activities is needed if they are to be effective in addressing stigma and health beliefs.
Community service providers' roles in supporting communication disability rehabilitation in Majority World contexts: An example from Ghana
Published in International Journal of Speech-Language Pathology, 2020
Karen Wylie, Bronwyn Davidson, Julie Marshall, Josephine Ohenewa Bampoe, Clement Amponsah, Lindy McAllister
Ghana is a tropical country situated along the Gulf of Guinea coast, with a population of ∼28 million (World Bank, 2018). Two approaches to rehabilitation co-exist in Ghana: health-related rehabilitation and community-based rehabilitation (Tinney, Chiodo, Haig, & Wiredu, 2007; Tuakli-Wosornu & Haig, 2014). The former is typically provided by professionals with specialised knowledge, based in health settings, such as physiotherapists. Community-based rehabilitation (CBR) is delivered in the community, by CBR workers, and addresses the needs of people with disabilities across five domains: health, education, livelihood, social and empowerment (World Health Organization & World Bank, 2011). Both approaches are insufficient in meeting the rehabilitation needs of the population in Ghana, including PWCD (Tinney et al., 2007; Tuakli-Wosornu & Haig, 2014).
Understanding rehabilitation in Ukraine from the perspective of key informants
Published in Disability and Rehabilitation, 2020
Anya Archer, Lisa Harper, Debra Cameron
To situate the qualitative data gathered in this research, literature related to models of disability and rehabilitation, international and civil engagement as well as the impact of conflict was reviewed. It is recommended that a variety of service delivery models are implemented when creating a comprehensive rehabilitation system [4]. For example, the social model of disability approach defines disability as, “the consequence of discrimination at the social and institutional levels” [5]. Similarly, Community-Based Rehabilitation (CBR) is a strategy designed to create an inclusive social environment through community development and equalization of opportunities for people with disabilities [4]. While both the social and CBR models focus on communities or groups of individuals, the social model focuses more broadly on institutional level issues that lead to systematic inequalities. These models both welcome the need for medical intervention as well as larger system level interventions [5]. Further, there is a need for policy and larger societal factors to be addressed in order to create an equalization of opportunities for people with disabilities at a community level [6].