CBR is a strategy that aims to address the rehabilitation, equalization of

opportunities, and social inclusion of people with disabilities through the

efforts of the community. It focuses on providing services and support to
people with disabilities in their own communities, rather than in
specialized institutions.

Community-Based Rehabilitation (CBR) is a strategy aimed at addressing

the needs of persons with disabilities in their own communities through
the combined efforts of persons with disabilities themselves, their
families, communities, and relevant government and non-governmental
organizations (NGOs). It was first introduced by the World Health
Organization (WHO) in collaboration with the International Labour
Organization (ILO) and the United Nations Educational, Scientific and
Cultural Organization (UNESCO) in the 1970s.

The reduction of the individual's problem and suffering won’t be enough for their whole life.
So the professional rehabilitation psychologist needs to see that there must be cooperation or
support system for the disabled to be leading life without or at least with minimum problems.
Institutions, social networks, family, community, if all put effort for improvement of life so
individual will be able to live a respectable life in the society.

Objectives of CBR

Enhancing Quality of Life: One of the primary objectives of CBR is to

enhance the quality of life of people with disabilities. This includes
improving their physical, mental, and social well-being, as well as their
access to education, employment, and other essential services.

Promoting Inclusion and Participation: CBR aims to promote the inclusion

and participation of people with disabilities in all aspects of life. This
includes ensuring that they have equal access to community resources,
services, and opportunities, and that they are able to participate fully in
social, recreational, and cultural activities.

Access to Essential Services: CBR seeks to provide people with disabilities

with access to essential services, such as healthcare, education, and
vocational training. This includes ensuring that these services are
accessible, affordable, and of high quality.

Empowerment: CBR aims to empower people with disabilities to advocate

for their rights and participate in decision-making processes that affect
their lives. This includes providing them with the skills, knowledge, and
resources they need to assert their rights and make informed choices.

1. Positive attitude be developed so one of the most important goal is

rehabilitation of community as a whole, that is to “prepare community” to
develop a mindset that this is our duty and the disabled have rights and
community is duty-bound towards them. Not to discriminate, maltreat
them. Assume that person with disability is as good or at par with others.
We are bound to treat them as normal person. Your duty is to fulfil their
day-to-day needs, cooperate, don’t isolate so that disabled considered
integral part of society and no sense of alienation is there. Support for
sports and recreational activities that promote physical health and social
integration. Establishment of peer support groups and counseling services
for individuals with disabilities and their families. The CBR programme in
Alexandria, Egypt, has several clubs that meet weekly in different parts of the city, including
in a local stadium and a mosque. Parents come with their children who have disabilities to
participate in activities organized by the CBR programme and community volunteers. There
is a range of fun activities for children, e.g. singing and dancing contests.

2. Quality education be provided to such persons like orthopedic not given

different education. It's the duty of community to provide quality
education so disabled won't ask for it, you are bound to give it and make
no separate institution for them and quality should be at par with others
and no separate education system be there as it is duty of community to
make such people literate. Inclusive Education Programs aim to
provide necessary support, such as special educators and learning aids, to
facilitate the inclusion of children with disabilities in mainstream schools.
Provision of physiotherapy services within schools to support children with
physical disabilities. Training educators to recognize and support students
with physical impairments.

3. Vocational education and training be given whether government or

non-governmental. As there is limitation with the organs of the disabled so
the training should be so that their capabilities be maximum utilized.
Along with vocational training, avenues provision and awareness of
avenues should be there which should be given as per the type and
degree of the impairment of the disabled individual. Establishment of
centers offering vocational training tailored to individuals with physical
disabilities. Government programs that help place individuals with
disabilities in suitable employment opportunities. Support for universities
and colleges offering physiotherapy programs to ensure a steady supply
of trained professionals. Funding and organization of workshops,
seminars, and courses for practicing physiotherapists to keep their skills
updated.

4. Self-employment should be encouraged. Make them aware how to

generate income and that these are the opportunities for you. Whatever
scheme you select, we will help you with it. Duty of community is to bring
them to mainstream of society and not let them in isolation. Disabled
person should not feel inferior to others. Community based rehabilitation
program makes sure community have a positive attitude and unless the
attitude changes, cooperation and integration can’t be taught. Positive
attitude doesn’t mean sympathy. development of positive attitude is
compulsory for development of community rehabilitation but everyone
has to participate willingly and not forcibly. Community members can
support microfinance initiatives and entrepreneurship programs that
empower individuals with disabilities to start their own businesses.

5. Health care services providing is an important goal. Providing

Functional rehabilitation to improve functional ability of the disabled
person. CBR programs often include providing physical,
occupational, and speech therapy, as well as access to
prosthetics, mobility aids, and other assistive devices that can
help individuals with disabilities live more independently. CBR
works with local authorities and community leaders to ensure that
disabled people are included in broader development projects,
such as building accessible infrastructure, improving public
transportation. Setting up checkup services in the locality for early detection of
neurodevelopmental disorders. CBR personnel identify a need for specialized rehabilitation
services, e.g. physiotherapy, occupational therapy, audiology, speech therapy, they can
facilitate access for people with disabilities by initiating referrals. The CBR programme in the
Islamic Republic of Iran encourages village health workers and CBR personnel to identify
people with disabilities early and refer them to the primary health-care services in the
community. Following referral, a mobile team of rehabilitation personnel visit the home to
provide home-based rehabilitation. If specialized interventions are required, referral is made
to a tertiary-level care centre, usually in the provincial headquarters or capital city. A CBR
programme in a poor area of Greater Mumbai, India, often involves staff from rehabilitation
institutions as trainers and teachers for CBR personnel. The CBR programme found that
many families with people with disabilities were afraid of going to referral hospitals for e.g.
ear, nose and throat (ENT), or ophthalmology care. So visits to referral hospitals were
organized for small groups of people with disabilities and their family members, to explain
how these hospitals worked and how people could access the different services.

6. Monitor or evaluate schemes for disabled and provide care. Institutions

in India work for improvement of life of people with disability by taking
grants from agencies for financial support without interest. Financial
institution won't say no, no bank can say loan is not for you. Banks and
NGOs provide financial structure and loan for self-employment of the
disabled and for functional rehabilitation. Interventions protect and
prevent from any risk. These provisions are community-bases
rehabilitation. Private institutes who give community-based program have
it mandatory for them the implementation of these things. Ensuring that
all individuals, regardless of disability, enjoy equal rights and
opportunities. Promoting the active participation of people with disabilities
in decision-making processes that affect their lives. Providing accessible
legal services and support to individuals with disabilities to protect their
rights and seek redress for violations. Implementing measures to protect
individuals with disabilities from violence, abuse, and exploitation.
7. Develop and distribute resource materials
Disability booklets and manuals can be a useful tool for rehabilitation. These resources can
be used by CBR personnel and by people with disabilities and their family members to guide
rehabilitation, particularly where access to rehabilitation professionals is limited. These
resources may also provide valuable information for the wider community as well as the
many different services and sectors involved in rehabilitation activities. The following CBR
activities are suggested.
 Locate existing resource materials. These may be available through government
ministries, United Nations bodies, disabled people's organizations or national and
international nongovernmental organizations, and many can be accessed from the
Internet, e.g. Training in the community for people with disabilities (32) and Disabled
village children
 Adapt materials to suit local requirements, giving special consideration to cultural
differences.
 Translate existing materials into national and/or local languages.
 Where existing resources are not available, develop new materials in simple language
to suit local needs.
 Distribute resource materials to all CBR personnel to carry with them when visiting
people with disabilities for rehabilitation.
 Create resource units where materials for people with disabilities, family members
and other members of the community are available. The units may be located in the
local development office, community health centre, or specific centres for people with
disabilities.

[Link] functional independence

Functional interventions aim to improve an individual's level of independence in daily living
skills, e.g. mobility, communication, bathing, toileting, dressing, eating, drinking, cooking,
housework. Interventions are dependent on a person's age, gender and local environment and
will change over time as she/he makes a transition from one life stage to another. CBR
personnel can provide:
 training for people with disabilities and their families about the different ways to carry
out activities;
 education for families on how to best assist people with disabilities in functional
activities to maximize their independence;
 training in the use of assistive devices, e.g. walking/mobility devices to make
activities easier;
 education and instruction on specific techniques used to address impairments, e.g.
muscle weakness, poor balance and muscle tightness, which impact a person's ability
to carry out activities; this might include strengthening, stretching and fitness
programmes.
A volunteer from the local CBR programme advised the family to fix a cord from her bed to
the toilet, so that during the night she could follow the cord to the toilet without waking her
family. A simple environmental modification ensured this grandmother's independence.

Advantages:

Specialized Care: Individuals receive specialized care from a team of

experts trained in rehabilitation medicine.

Comprehensive Services: Institutions offer a wide range of services in one

location, making it convenient for patients and their families.

Intensive Therapy: The intensive nature of therapy in institutions can lead

to faster and more significant improvements in function.

Disadvantages:

Cost: Institution-based rehabilitation can be expensive, especially for long-

term care.

Isolation: Individuals in institutions may experience social isolation from

their communities and families.

Dependence: Long-term care in institutions can lead to dependence on

institutional care, limiting independence and community integration.