Community Based Rehabilitation(CBR) may be defined, according to three United Nation Agencies, ILO, UNESCO, and the WHO, as a “strategy within community development for the rehabilitation, equalization of opportunities, and social integration of all people 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” (WHO, 1994).
Institutional Rehabilitation provides excellent services to address the problems of individual disabled persons and is often available only for a small number at a very high cost. CBR as the name implies has have found in the community, its roots in the community and has to derive sustenance and support from the community. They should be rehabilitated in their community by and with people in their community. CBRfocuses on * enhancing the quality of life for people with disabilities and their families, * meeting basic needs and * ensuring inclusion and participation.
CBR was initiated in the mid-1980s but has evolved to become a multi-sectoral strategy that empowers persons with disabilities to access and benefit from education, employment, health and social services. CBR is implemented through the combined efforts of people with disabilities, their families, organizations and communities, relevant government and non-government health, education, vocational, social and other services.Mainstreaming and inclusion is seen as an effective way:to include persons with disability;to give equal opportunity and to provide a non discriminative environment for their growth and development In practical terms this means persons with disability are included in the programmes and schemes formulated by the government and others, not as mere beneficiaries but as equal members who can participate with full recognition of and exercise their rights.
Need of CBR Institutional overheads and other major infrastructural expenses make the process very expensive. Moreover, the endeavours in an institution are often out of context to the felt needs of the disabled person, and thus falls short of their expectations. The fact that this person comes from a particular background and cultural setting is often ignored. The institutional culture is imposed on the disabled person and they are often expected to function as advised by the “experts”. In an institutional rehabilitation programme, the community is not linked with the process. Hence, when the disabled persons return home, it may become difficult for them to integrate into their community.
Disability -Situation Time line In the 70s it was based on western health care model largely urban based and not cost effective. No real service provision for disabled. In the 80s/90s there was a shift from medical towards employment and community development. In real terms this was a social model. In the year 2000 CBR perceived in terms of Human rights and involvement and awareness of disabled persons was advocated. WHO approach emphasizes basic rehabilitation involving working partnership with local community, disabled, family, governments and professionals at regional and national levels.