Community Based Rehabilitation

Center - Need and Importance

Done by, Sreelaxmi Kallan Sarosh
23396
 Contents
• Introduction
• Understamdimg Rehabilitation
• Challenges in traditional rehabilitation
• Need for CBRC
• Principles
• Useful initiatives
• Benefits of CBRC
• Key components
• CBR team
• Case studies
• Importance
• Steps
• Challenges and solution
• Conclusion
• References
 Introduction
CBR is a strategy that aims to improve the quality of life for people with diabailities
and their families and ensure their inclusion in the community

The WHO introduced CBR in the late 1970s primarily as a service delivery method
aimed at bringing primary health care and rehabilitation services close to people
with disabilities
Definition

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).
CBR FOCUSES ON

● Enhancing the quality of life for people with disabilities and their families,
● Meeting basic needs and
● Ensuring inclusion and participation
 BASIC PRINCIPLES OF CBR

1. Inclusion- means the removal of all kinds of barriers which block People
with Disabilities (PWDs) from access to the mainstream.

2. Participation.

3. Sustainability.

4. Empowerment.

5. Advocacy.
 The key purposes

- Empower people with disabilities to participate

fully in society
- Promote the rights, inclusion, and independence
of individuals with disabilities
- Improve access to healthcare, education,
employment, and social services
- Challenge stigma and discrimination against
people with disabilities
- Enhance the overall quality of life for individuals
with disabilities
- Foster their active involvement in community
development initiatives
 Understanding Rehabilitation
Rehabilitation is a process aimed at restoring, maintaining, or improving
physical, mental, and social well-being of individuals affected by illness,
injury, or disability.
Importance in Healthcare:
● Restoring functionality
● Improving quality of life
● Preventing complications
● Facilitating integration
● Reducing healthcare costs
 Challenges of Traditional Rehabilitation

Limitations of Traditional Rehabilitation Methods:

- One-size-fits-all approach
- Symptom-focused, not holistic
- Lack of interdisciplinary integration
- Minimal use of technology
- Insufficient emphasis on patient empowerment
Barriers to Accessing Rehabilitation Services:
- Geographical limitations
- Financial constraints
- Transportation challenges
- Long waiting times
- Inadequate insurance coverage
 Need for CBRC
Gaps in Traditional Rehabilitation Services:

- Limited accessibility, especially in rural areas

- Lack of community integration and support
- Insufficient focus on holistic, patient-centered care
- Fragmented services and lack of coordination between healthcare providers
- Inadequate attention to cultural and social factors affecting rehabilitation
 Need for CBRC

How CBRCs Can Bridge These Gaps:

- Bring rehabilitation services closer to
communities, enhancing accessibility
- Foster community involvement and
support networks for individuals undergoing
rehabilitation
- Provide holistic care addressing physical,
mental, and social aspects of well-being
- Promote interdisciplinary collaboration
among healthcare professionals and community
stakeholders
- Tailor services to meet the diverse cultural and
social needs of individuals and communities
 Benefits
1. Accessibility
2. Holistic Approach
3. Inclusive Environment
4. Tailored Services
5. Support Network
6. Cost-Effectiveness
7. Promotion of Independence
 Key Components

1. Community Engagement and Involvement

2. Multidisciplinary Team Approach
3. Holistic Care Delivery
4. Cultural Sensitivity and Inclusivity
5. Accessible Infrastructure and Resources
6. Education and Capacity Building
7. Collaboration and Networking
8. Outcome Monitoring and Evaluation
 CBR Team

1. Patient
2. Patient's relatives
3. Community-Based Rehabilitation worker
4. Locally available skilled workers
(e.g., carpenters)
5. Local leader
6. School teacher
7. Multipurpose rehabilitation worker
8. Primary Health Care (PHC) staff including
medical officer and other health workers
9. District administrative officer
10. Specialized professionals such as psychiatrist, physiotherapist,
occupational therapist, orthotists, and prosthetic engineers.
 Useful initiatives for CBR

● Social counseling
● Training in mobility and daily living
skills
● Providing or facilitating access to
loans
● Community awareness raising
● Providing or facilitating vocational
training/apprenticeships
● Facilitating information for local
self-help groups, parents groups and
● Disabled People’s Organizations
(DPOs)
● Facilitating contacts with different
authorities
● Facilitating school enrolment (school
fees and contacts with teachers/)
 Case Studies
Kerala's BUDS initiative

The Kudumbashree initiative in Kerala exemplifies a holistic approach to the

rehabilitation and empowerment of mentally challenged individuals through its BUDS
Rehabilitation Centres (BRCs).
Emphasizing Community Based Participatory Rehabilitation (CBPR) methodology,
these centres focus on training, day care, and health care for mentally challenged
persons above 18 years old, aiming to integrate them into society while providing
vocational skills tailored to their capabilities.
With support from local government institutions, the BRCs ensure a safe and
supportive environment, offering infrastructure, staff, and training in areas like adult
living skills and vocational training.
By engaging families, neighbourhood groups, and potential employers, the initiative
promotes social inclusion and self-dependence, showcasing a model of
comprehensive care and community involvement in rehabilitation efforts.
 Karnataka ‘ Samarthanam Trust
Samarthanam Trust for the Disabled operates community-based rehabilitation programs
across Karnataka, focusing on empowering persons with disabilities through education,
skill development, and livelihood opportunities
Samarthanam's rural initiatives in Chilamathur Mandal prioritize holistic development,
focusing on economic, social, and educational aspects, with a strong emphasis on
serving people with disabilities (PwDs).
The center offers essential services such as a day care center for children with
intellectual disabilities, caregiver training, assistive device camps, and awareness
campaigns. Their impact is evident, with significant reductions in vaccination hesitancy
and improved access to healthcare services.
Moving forward, Samarthanam plans to expand their community-based rehabilitation
efforts, promoting growth activities, setting up mobile physiotherapy clinics, and
supporting skill development and higher education for PwDs, all aimed at empowering
rural communities and individuals with disabilities.
 Importance of Community Engagement

Importance of Community Engagement:

1. Inclusivity
2. Support System
3. Sustainability
4. Cultural Sensitivity
Strategies for Engaging the Community in Rehabilitation Efforts:
1. Community Awareness Programs
2. Collaborative Partnerships
3. Involvement in Program Planning
4. Volunteer Programs
5. Peer Support Groups
6. Accessible Communication Channels
7. Cultural Events and Festivals
8. Empowerment Programs
 Steps in implementation of CBR
I. Identification of Person Requiring Rehabilitation Services
II. Assessment of Disabilities and Various Needs for Rehabilitation of Identified
Person
III. Provision of Basic Services through Primary Health Care (PHC)
IV. Introduction/Escorting to Village Health & Sanitation Committee
V. Referral to Secondary or Tertiary Care Center for Physical Rehabilitation
Services
VI. Facilitating Accessibility to Socio-Economic Rehabilitation Services
VII. Review Meetings by All Stakeholders
VIII. Role of District Nucleus in Steering Rehabilitation Activities
IX. Coordination with Social Welfare Department
 Challenges and Solutions

Challenges in Implementing CBRCs:

1. Limited Awareness and Understanding
2. Resistance to Change
3. Resource Constraints
4. Fragmented Healthcare Systems
5. Stigma and Discrimination
Solutions and Strategies:
1. Community Education and Awareness Campaigns
2. Stakeholder Engagement and Collaboration
3. Resource Mobilization and Capacity Building
4. Integrated Service Delivery Models
5. Advocacy and Sensitization Programs
 Conclusion

Community-Based Rehabilitation Centers (CBRCs) address challenges in traditional rehabilitation by:

- Providing localized and accessible services.
- Involving communities for support and inclusivity.
- Offering holistic care tailored to individual needs.
- Fostering interdisciplinary collaboration.
- Considering cultural and social factors affecting rehabilitation.
Strategies for CBRC success involve:
- Raising awareness and education.
- Building partnerships and collaborations.
- Mobilizing resources and capacity.
- Implementing integrated service models.
- Advocating for acceptance and inclusivity.
In conclusion, CBRCs are essential for promoting inclusive healthcare by empowering individuals,
engaging communities, and fostering holistic rehabilitation approaches that address diverse needs
effectively.
 References
● https://samarthanam.org/rural-initiatives/
● https://karnatakaphysio.org/pdf2/Community_Based_Rehabilitation.pdf
● https://www.ncbi.nlm.nih.gov/books/NBK310933/
● https://thekudumbashreestory.info/index.php/programmes/social-empowerm
ent/buds-school/buds-rehabilitation-centers-brc
● https://www.ncbi.nlm.nih.gov/books/NBK310933/
● https://www.who.int/publications-detail-redirect/9789241548052
● https://www.slideshare.net/JobinJacob23/community-based-rehabilitation-23
2552740
Thank You!!