Community Based Rehabilitation (CBR) is a community development strategy that aims at enhancing the lives of persons with disabilities (PWDs) within their community. It emphasizes utilization of locally available resources including beneficiaries, the families of PWDs and the community. According to the UN Convention on the Rights of Persons with Disabilities, comprehensive rehabilitation services focussing on health, employment, education and social services are needed to enable PWDs/CWDs attain and maintain maximum independence, full physical, mental, social and vocational ability, and full inclusion and participation in all aspects of life (UN, 2006).
The basic principles of CBR are:
- Utilization of available resources
- Transfer of knowledge about disabilities and skills in rehabilitation to PWDs, families and communities
- Community involvement in planning, decision-making, implementation and evaluation
- Utilization and strengthening of referral services
- Utilization of a co-ordinated and multi-sectoral approach
The evolution of CBR into a broader multi-sectoral development strategy led to the development of a matrix to provide a common framework for CBR service delivery. The matrix delineates five key components of service delivery for PWDs and their families. These are: health, education, livelihoods, social and empowerment. Each of these components forms a model of implementation. The CBR models are:
- The Medical Model/perspective, which emphasizes the need for medical procedures such as corrective surgery as the ideal intervention required to enhance the life of PWDs.
- The Education Model, which emphasizes skills development and therefore provides the background for education provisions for PWDs such as introduction of special schools, integration and inclusive education.
- The Economic Model, which argues that enhancement of the lives of PWDs is attained as long as they are economically empowered to afford basic needs. It is the basis for livelihood interventions
- The Social Model, which argues that activity limitation and participation among PWDs result from environmental factors. The model therefore emphasizes elimination of barriers to participation as the best intervention to enhance the lives of PWDs.
- The Comprehensive Model, which appreciates efforts by all the other models and encourages provision of each of the aspects to enhance the lives of PWDs. It also encourages use of the twin-track approach where both individuals and the system/environment are addressed concurrently.