Presbyterian CBR has structured it’s activities and interventions using the Community Based Rehabilitation organizational model produced by the World Health Organization. Below you will find a brief overview of the model and links to Presbyterian CBR’s work within this model’s components.

CBR MATRIX-01

CBR was initiated by the WHO following the alma-alta in 1978. It was promoted as a strategy to improve access to rehabilitation services for people with disabilities in low and middle income countries, by making optimum use of local resources. Since then it has worked with UN organizations, nongovernmental organizations and disabled peoples organizations; and has evolved into a multisectoral strategy to address the broader needs of people with disabilities, ensuring their participation and inclusion in society and enhancing their quality of life. The CBR Model focuses on 5 key components aimed at improving the lives of people with disabilities:

Health

The Constitution of the World Health Organization (WHO) states that “enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition” Unfortunately, evidence shows that people with disabilities often experience poorer levels of health than the general population and face various challenges to the enjoyment of their right to health. Community-based rehabilitation (CBR) programmes support people with disabilities in attaining their highest possible level of health, working across five key areas: health promotion, prevention, medical care, rehabilitation and assistive devices. CBR facilitates inclusive health by working with the health sector to ensure access for all people with disabilities, advocating for health services to accommodate the rights of people with disabilities and be responsive, community-based and participatory. Specific services include;

  • Advisory services in blindness prevention and sight restoration by way of referrals, medical treatment or surgery
  • Organizing health promotion talks through community durbars and radio programmes
  • Orthopaedic and Physiotherapy services
  • Audiological services
  • Mental health services (Management of epileptic seizures and other mentally related disorders)
  • Prevention of childhood disability activities through a multi-sectorial collaboration
  • Provision of rehabilitation services to persons with disabilities
  • Provision of basic assistive devices to persons with disabilities
  • Prevention of childhood disabilities using a multi-disciplinary team screening approach

Learn more about our work with health.

Education

Education is about all people being able to learn what they need and want throughout their lives, according to their potential. It includes “learning to know, to do, to live together and to be”. Education takes place in the family, the community, schools and institutions, and in society as a whole. The role of CBR is to work with the education sector to help make education inclusive at all levels, and to facilitate access to education and lifelong learning for people with disabilities. This include;

  • Referrals of Children with disabilities to special Schools from primary, secondary and tertiary
  • Provision of lifelong learning activities for the severely disabled persons
  • Early Childhood intervention
  • Integration of Children with mild disabilities into the regular school system

Learn more about our work with education.

Livelihood

People with disabilities in low-income countries are affected by the same factors which cause poverty for others, but also face added disadvantages. Children with disabilities face barriers to education; youth with disabilities face barriers to training; adults with disabilities face barriers to decent work. Most damaging of all, families and communities may think that people with disabilities are incapable of learning skills and working. By encouraging and facilitating work by women and men with disabilities, community-based rehabilitation (CBR) programmes can help individuals and their families to secure the necessities of life and improve their economic and social situations. By taking into consideration the needs and views of people with disabilities and making provision for their inclusion in national poverty reduction and other development programmes, opportunities for education, skills acquisition and work can be provided for people with disabilities and their families, enabling them to emerge from poverty. Accessing livelihood opportunities is one of the key factors in eliminating poverty.

Under this component CBR is to facilitate access for people with disabilities and their families to acquiring skills, livelihood opportunities, enhance participation in community life and self-fulfillment

  • Engaging vulnerable groups/individuals in economic activities (PWD’s and mental health clients in productive income generating ventures)
  • Micro – credit for the vulnerable groups
  • Vocational skill training/ skill development for young disabled adults/persons with mental illness
  • Linking persons with disabilities/individuals to financial institutions for credit
  • Animal rearing/Credit in-Kind system(cashless system)
  • Handicrafts

Learn more about our work with livelihood.

Social

Being actively included in the social life of one’s family and community is important for personal development. The opportunity to participate in social activities has a strong impact on a person’s identity, self-esteem, quality of life, and ultimately his/her social status. Because people with disabilities face many barriers in society they often have fewer opportunities to participate in social activities. The role of CBR is to work with all relevant stakeholders to ensure full participation of people with disabilities in the social life of their families and communities. CBR programmes provide support and assistance to people with disabilities to enable them to access social opportunities, and can challenge stigma and discrimination to bring about positive social change.

Under this component CBR seeks to work with all stakeholders to ensure the full participation of persons with disabilities in the social life of their families and communities. The program provide support and assistance to persons with disabilities to enable them access social opportunities and challenge stigma and discrimination to bring about positive change.

  • Ensuring  that the vulnerable groups that we work with/ for have good relationship/marriages with the family/community members
  • Ensuring culture/religious  participation of the vulnerable groups
  • Ensuring that persons with disabilities have access to justice

Learn more about our work with social inclusion.

Advocacy and Empowerment

While the first four components of the matrix relate to key development sectors (i.e. health, education, livelihood, and social sectors), the empowerment component focuses on the importance of empowering people with disabilities, their family members and communities to facilitate the mainstreaming of disability across each sector and to ensure that everybody is able to access their rights and entitlements. Empowerment begins to happen when individuals or groups of people recognize that they can change their situation, and begin to do so. It is a process that involves things like awareness and capacity-building leading to greater participation, to greater decision-making power and control, and to action for change Having a say and being listened to promotes a self-power to make decisions which allows people with disabilities to live free and independent with the ability to fight for their own rights and gain recognition as equals.

Under this component CBR seeks to assist persons with disabilities to develop advocacy and communication skills and, to ensure that their environment provides appropriate opportunities and support to allow them to make decisions and express their needs and desires effectively.

Currently the CBR programme has established forty five (45) Disable People Organisations (DPOs) and twenty three (23) Self-Help-Groups of persons with mental illness

  • Awareness creation on rights based issues on disabilities
  • Establishment of Disable People Organisations (DPOs)
  • Establishment of Self-Help-Groups in working communities
  • Establishment of community Development Committees to spear head development at the community level.
  • Social mobilization at the community level for development.
  • Provision of training on group dynamics

Learn more about our work with empowerment.

Cross-cutting Issues (Child Protection and HIV/AIDS Issues)

HIV/AIDS Programme: The role of CBR is to

(i) ensure that people with disabilities and their families are aware of the HIV/AIDS programmers and services in their communities;

(ii) ensure that HIV/AIDS programme and services are accessible for people with disabilities and their families;

(iii) include in its programmes people living with HIV/AIDS who may be experiencing temporary or permanent disability.

  • HIV/AIDS awareness creation within the operational area
  • Train People Living With HIV/AIDS ( PLWHAs) in vocational skills
  • Care and support for PLWHAs
  • Establishing networks and partnerships with between disability and HIV/AIDS stakeholders
  • Key development sectors include people living with HIV/AIDS
  • National HIV/AIDS policies and plans include people with disability

Child Protection: CBR seeks to protect children both with and without disabilities (and vulnerable adults) from sexual exploitation and sexual, emotional or physical abuse, including neglect.

  • Awareness creation and sensitization of major stakeholders on child rights within operational area
  • Establishment of community Development Committees to spear head development at the community level.
  • Social mobilization at the community level for development.
  • Provision of training on group dynamics

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© World Health Organization 2010 

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