Community Based Rehabilitation

Community Based Rehabilitation (CBR) has been promoted internationally for more than 30 years as a strategy for improvement in the quality of life and services for people with disabilities: “Community Based Rehabilitation is a strategy within community development for the rehabilitation, equalisation of opportunities and social inclusion of all adults and children with disabilities. CBR is implemented through the combined efforts of disabled people themselves, their families and communities and the appropriate health, education, vocational and social services.” ILO, UNESCO, WHO Joint Position Paper 2004.

Unlike other conventional rehabilitation programmes, which tend to be simply medical and institutional, CBR is categorically based within a community development framework. The strategy of CBR places equal emphasis on inclusion, equality and socio-economic development as well as rehabilitation of all people with disabilities. CBR is also formally recognised by the South African government in their Integrated National Disability Strategy (INDS) White Paper as ‘forming the basis of the national rehabilitation strategy’ (ODP, 1997; p.27).

Recently in the World Health Organisation’s CBR Guidelines (2010) community based rehabilitation is understood as a strategy for disability-inclusive development.

The five components (health, education, livelihoods, social and empowerment) each have five key elements which inform the implementation of CBR. Both the components and their elements are underpinned by the principles of participation, inclusion, sustainability and self-advocacy. According to the World Health Organisation (WHO, 2010) these principles should inform and affect the activities within each of the topic areas.

In using this matrix, CBR programmes may only address some of the components and elements, depending on local circumstances. For example, in South Africa, many of the CBR programmes were historically set up through the Department of Health and therefore focus mainly on the health component. However they also include elements such as early childhood development, self-employment through income generating activities and self-help groups. This demonstrates how elements of CBR can be inter-related.