SEMINAR ON COMMUNITY BASED REHABILITATION

INTRODUCTION
Rehabilitation, considered as functional restoration, can be achieved only by empowering the disabled as well by enriching their community. It amounts to development of the community as a whole, empowering the disabled persons to achieve their complete potential, enabling them to integrate into the fabric of the community and make decisions for themselves

INTRODUCTION CONT.
Empowering the disabled persons may involve medical, social, vocational and educational inputs. Enriching the community involves education, creating awareness, providing basic resources, changing attitudes and building constructive approaches towards disability and related problems.

DEFINITIONS
CBR Working Group (1997) Definition : In the CBR context, community means (a) a group of people with common interests who interact with each other on a regular basis; and/or (b) a geographical, social or Government administrative unit ILOs Definition: Rehabilitation involves the combined and coordinated use of medical, social, educational and vocational measures for training or retraining the individual to the highest possible level of functional ability.

DEFINITIONS CONT
CBR is a strategy for enhancing the quality of life of disabled people by improving service delivery, by providing more equitable opportunities and by promoting and protecting their human rights (E. Helander ) 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.

COMPONENTS

Medical, psychiatric, psychological, social, and vocational services that are provided under one management Testing, fitting, or training in the use of prosthetic and orthotic devices Recreational therapy Physical and occupational therapy Speech, language, and hearing therapy Psychiatric, psychological, and social services, including positive behavior management Assessment for determining eligibility and vocational rehabilitation needs Rehabilitation technology

COMPONENTS CONT

Job development, placement, and retention services Evaluation or control of specific disabilities Orientation and mobility services for individuals who are blind Extended employment Psychosocial rehabilitation services Supported employment services and extended services Services to family members when necessary to the vocational rehabilitation of the individual Personal assistance services

OBJECTIVES OF COMMUNITY REHABILITATION

To ensure that PWDs are able to maximize their physical and mental abilities, to access regular services and opportunities, and to become active contributors to the community and society at large. To activate communities to promote and protect the human rights of PWDs through changes within the community, for example, by removing barriers to participation. To establish the local communities to create awareness about persons with disabilities, recognize their rights and accept at least part of responsibility for their rehabilitation

OBJECTIVES OF COMMUNITY REHABILITATION CONT.

To motivate the local communities to mobilize their own resources - human, material and financial, including persons with disabilities themselves, their families and friends to take an active part in rehabilitation training To organize training for personnel at different levels and to use appropriate training material. To deliver services built upon existing community, organizational infrastructure, especially primary health care services To establish a referral network to meet needs which cannot be met locally and work in conjunction with other sectors viz. education, vocational, employment etc. To ensure strong political commitment for the promotion of CBR

BASIC PRINCIPLES OF A CBR PROGRAMME

Equality Social justice Solidarity Integration Dignity

BASIC PRINCIPLES OF A CBR PROGRAMME CONT

Inclusion Participation Sustainability Empowerment Advocacy

COMMUNITY REHABILITATION TEAM

Community Rehabilitation Team (CRT) is a community based multi-disciplinary team offering a service to adults with significant physical and cognitive disabilities.

COMMUNITY REHABILITATION TEAM

The multidisciplinary team consists of members from: Occupational Therapy Physiotherapy Speech Pathology Psychology Neuropsychology and Clinical Psychology Social Work Prosthetics and Orthotics Exercise therapy (gym and hydrotherapy). Vocational Rehabilitation Rehab coordinator Rehabilitation physician

MULTI-SECTORAL SUPPORT FOR CBR

Support from the Social Sector Support from NGOs and the local community Support from the Health Sector Support from the Educational Sector Support from the Employment and Labor Sector Support from the Media

TRENDS IN COMMUNITY BASED REHABILITATION Information technology revolution Economic restructuring Democratization Environment Ageing Multiculturalism

OTHER TRENDS
Movement towards better acceptance of CBR More research

METHODS OF COMMUNITY REHABILITATION

Occupational Rehabilitation Physical Rehabilitation Aquatic Rehabilitation Cognitive Rehabilitation Speech/Swallowing Therapy Balance Therapy Respiratory Therapy Vision Therapy

MODELS OF REHABILITATION
1.The Traditional Model 2.The Medical Model 3.The Social Model

ISSUES IN COMMUNITY BASED REHABILITATION Lack of standardisation Lack of recognition and accreditation Lack of a career ladder Unavailability of appropriate trainers Turnover

GOVERNMENT INITIATIVES IN COMMUNITY REHABILITATION

District Rehabilitation Center (DRC) Project started in 1985. National Information Center on Disability and Rehabilitation National council for Handicapped Welfare National Level Institutes-NIMH, NIHH, NIVH, NIOH, IPH. District Disability Rehabilitation Centre The National Policy for Persons with Disability 2005 Arushi

REHABILITATION SERVICES IN INDIA

MINISTRY OF SOCIAL JUSTICE AND EMPOWERMENT MINISTRY OF HEALTH AND FAMILY WELFARE,HRD,LABOUR,INFORMATION AND BROADCASTING REGIONAL AND DISTRICT REHABILITATION CENTRES REHABILITATION COUNCIL OF INDIA OCCUPATIONAL THERAPY SCHOOL(MUMBAI,NAGPUR) ALL INDIA INSTITUTE OF PHYSICAL MEDICINE AND REHABILITATION(MUMBAI) OCCUPATIONAL THERAPY COLLEGE ,MUMBAI NATIONAL INSTITUTE OF MENTALLY HANDICAPPED(NIMH) SECUNDERABAD ALI YAVAR JUNG NATIONAL INSTITUTE FOR HEARING HANDICAPPED MUMBAI NATIONAL INSTITUTE OF VISUALLY HANDICAPPED,DEHRADUN NATIONAL INSTITUTE OF ORTHOPEDICALLY HANDICAPPED,KOLKATA

OTHER INITIATIVES
Community Based Rehabilitation (CBR) Forum : Established in 1996 is secular, non-profit organisation. CBR Forum plays a proactive and promotional role in Community Based Rehabilitation of Persons with Disabilities in India and in the inclusion of persons with disabilities in community development programmes.

ROLE OF NURSE IN COMMUNITY REHABILITATION Practitioner Care coordinator Advocate Educator Consultant Researcher

CONCLUSION
Community-based rehabilitation (CBR) focuses 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..

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