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An Evaluative Study of Services Provided in Community-Based Rehabilitation Centres in Jordan

Darawsheh, Wesam B
2018

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Purpose: This research study aimed to investigate the effectiveness of the services provided by CBR programmes in Jordan.

 

Method: This was a mixed-methods investigation. A survey was carried out with 47 participants (stakeholders and volunteers) from four CBR centres in Jordan. It comprised 18 questions that collected both qualitative and quantitative data with both closed- and open-ended questions. The quantitative data was analysed using SPSS Version 22.0. Qualitative data was analysed through thematic content analysis and open coding to identify emergent themes.

 

Results:  40.4% of the participants evaluated the effectiveness of CBR services as low. This mainly stemmed from the lack of efforts to increase the local community’s knowledge about CBR, disability and the role of CBR programmes towards people with disabilities.

 

Conclusions: A proposal was offered concerning the priorities of CBR programmes in Jordan. Efforts need to be directed at promoting livelihood and empowerment components in order to actualise the principles of CBR, mainly by promoting multispectral collaboration as a way of operation.

 

Implications: This study was inclusive of all types of disability.  Barriers to the effectiveness of services may stem from accessibility issues to the families of persons with disabilities (hard to reach) or from CBR services themselves (hard to access). The culturally specific evaluative tool in this study was of “good” specificity and sensitivity, this evaluative instrument can be transferrable to measure the impact of CBR programmes in other settings. 

Social inclusion and mental health of children with physical disabilities in Gaza, Palestine

NASSER, Khaled
MACLACHLAN, Malcolm
MCVEIGH, Joanne
2016

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Purpose: Social inclusion of children with physical disabilities is essential for their mental health. The long-standing conflict and political instability in Palestine since 1948 has resulted in an unprecedented number of children with disabilities. This study aimed to assess social inclusion and mental health of children with physical disabilities in Palestine.

 

Method: A mixed methods research design was used. The 12-item General Health Questionnaire and a Social Inclusion Questionnaire were administered to 100 children with amputations, 12-18 years of age, in the Gaza Strip. Ten semi-structured interviews were also conducted with personnel working across civil society rehabilitation services in the area, particularly in services that focussed on the physical rehabilitation of children who had lost a limb.

 

Results: Quantitative findings indicated that 88% of children’s disabilities were caused by war-related incidents. While the sample of children showed on average relatively low levels of psychological distress, males reported feeling more socially included and having better mental health than did females. Furthermore, there was a strong positive correlation between mental health and social inclusion, and a moderate positive correlation between psychological distress and social inclusion. The qualitative data identified different factors that hinder social inclusion, mainly: political instability; under-resourced disability organisations; lack of coordinated efforts; and negative societal attitudes towards disability.

 

Conclusion: A new questionnaire for social inclusion was developed, which can now be used as a tool to assess social inclusion in similar contexts; as well as a culturally-adapted form of the General Health Questionnaire-12 to assess mental health. There is a clear need for service-providers to move beyond a medical model of care to one that embraces community-based rehabilitation and the realisation of rights, in order to promote the social inclusion and mental health of children with disabilities in Palestinian society.

Community-based rehabilitation in a post-soviet environment in Azerbaijan : where society meets ideology

BURCHELL, Gwen
2015

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This paper explores UAFA’s experience, since 2002, in working with Azerbaijani stakeholders to move from the medical approach to disability, propagated by the Soviet model of planning and implementation, to a social, community-based approach. The paper highlights the common misconceptions and how these can be overcome, including the policy gaps that challenge effective implementation.

 

The importance of creating and maintaining a core team is discussed, alongside the process that UAFA has developed for building up teams of CBR workers. Finally, the paper raises the issue of introducing outcomes-based evaluation in a society that has no such prior experience, followed by an account of the continual challenge faced by most programmes–namely, how to achieve sustainable funding.

 

 

Disability, CBR and Inclusive Development, Vol 26, No 3

Empowerment and participation : good practices from South & South-East Asia in disability inclusive disaster risk management

BOLTE, Patrick
MARR, Samadhi
SITOMPU, Dewi
et al
2014

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This report presents good practices showing examples of inclusion and active participation of persons with disabilities in disaster risk management. The paper is structured in three sections that illustrate general recommendations towards greater participation of persons with disabilities.

Section A provides the background on disability inclusive disaster risk management and reviews existing guidelines as to how the participation of people with disabilities in disaster risk management can be facilitated. 

Section B contains the actual good practices, structured in three separate chapters that illustrate general recommendations towards greater participation of persons with disabilities. Each practice highlights the involvement of individual persons as well as groups, describes the initial setting, the achievements, and the lessons learned from the practice. Each practice concludes with a box with key insights.

The final section C presents the key recommendations that can be drawn from the good practices and that are geared to inform future programming

Shoulder Pain among Rehabilitated Spinal Cord Injured Persons Using Manually Propelled Wheelchairs in the Gaza Strip: A Survey

EL ESSI, K
EL-SHAFIE, J M
AL HAWAMDAH, Z
ZAQOUT, S I
2012

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Shoulder pain among paraplegic persons has negative effects on their lives. The prevalence of shoulder pain among persons with spinal cord injury (SCI) varies from 30% to 70% in different studies and may be related to repetitive use of the shoulder during self-care and wheelchair-related activities.

 

Purpose: This study focused on the prevalence of shoulder pain and examined its effects on activities of daily living and social participation, and on functional, work and recreational or athletic activities. It also aimed to detect the degree ofsatisfaction with shoulder functioning in wheelchair users who were paraplegic due to spinal cord injury, in the Gaza strip.

 

Methods: Cross sectional study design was used to collect data from 80 persons with paraplegia, post rehabilitation, who were still using manual wheelchairs (MWC) for ambulation. After giving informed consent, the selected persons were interviewed directly in their homes, and filled questionnaires which included demographic data, Wheelchair User’s Shoulder Pain Index (WUSPI) and Shoulder Rating Questionnaire (SRQ).

 

Results: The prevalence rate of shoulder pain among paraplegics who use manual wheelchairs was 62%. Pushing a wheelchair for 10 minutes or more, and propulsion up ramps or inclines outdoors were the most common activities that caused and exacerbated shoulder pain. Sixty four percent from among the study sample mentioned that they had no limitation in shoulder-using ability during daily personal and household activities, while the rest experienced different degrees of limitation. Seventy-four percent reported no limitation during recreational or athletic activities, while the rest (26%) agreed that pain has variably limited their participation in these activities. Fourteen percent from the sample rated the overall degree of satisfaction with their shoulder functioning as fair, and the rest rated their satisfaction from good to excellent.

 

Conclusion: Shoulder pain, ranging from mild to severe, was highly prevalent among SCI paraplegics who use MWCs during their usual activities, and other activities which involve wheelchair propulsion. About two- thirds of the subjectsreported no limitation in shoulder use during daily personal and household activities and in recreational or athletic activities.

Regional framework on community-based rehabilitation : pilot version

WORLD HEALTH ORGANIZATION (WHO), Regional Office or the Eastern Mediterranean (EMRO)
2011

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This regional framework was developed from an inter-country initiative by national authorities and independent experts within the WHO Eastern Mediterranean Region to develop a community-based rehabilitation strategy to put into effect the provisions of the of the United Nations Standard Rules on the Equalization of Opportunities for People with Disabilities (1993) and Convention on the Rights of Persons with Disabilities (2006). It details the CBR strategic objectives, key approaches to achieving them and indicators of success

CBR stories from Africa : what can they teach us?

COLERIDGE, Angela
HARTLEY, Sally
Eds
2010

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"Community Based Rehabilitation (CBR) is an evolving concept. Its effectiveness depends on continuous reflection, debate and learning. This book aims to facilitate this process through the stories of five CBR programmes in Africa, told by those involved with the programmes and reflected on with honesty...Each of the five programmes has been invited to document their work, describing how its programme started and assessing the effectiveness of the approach it has chosen. They were asked to identify their successes and challenges, and to reflect on how difficulties are being overcome. Life stories illustrate the impact each approach can have on individual lives. The book offers itself as a reflective tool, to be used by practitioners. Each chapter asks specific questions of its readers, inviting them to draw comparisons with their own programme. The concluding section of the book outlines ideas for evaluating and developing their CBR programmes"

WHO/ILEP technical guide on community-based rehabilitation and leprosy

WORLD HEALTH ORGANIZATION (WHO)
INTERANTIONAL FEDERATION OF ANTI-LEPROSY ASSOCIATIONS (ILEP)
2007

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This technical guide provides a reorientation and familiarisation tool for managers of leprosy projects and programmes. The analysis includes an outline of the broad objectives of CBR, the roles and tasks of programme managers, and the responsibilities of community workers. This resource would be useful for anyone with an interest in disability and development

Evaluation of the CBR program in Palestine : from the perspective of persons with disabilities themselves

NILSSON, Annika
QUTTEINA, Malek
December 2005

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"This report documents an evaluation of the Community Based Rehabilitation program (CBRP) in Palestine that investigated the impact of the program from the perspective of disabled people and their families. The main objectives of the evaluation were to ascertain to what extent the CBRP has contributed to improving the quality of life of disabled people and suggest ways in which the program can more effectively meet the needs of people with disability"

Afghanistan : community based approach to parents with disabled children : reality or ambition?

TURMUSANI, Majid
May 2005

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The article discusses the exclusion of people with disabilities from mainstream services and activities in Afghanistan, the CBR initiatives to support families with disabled children and their limitations. A number of recommendations are made on how CBR as a comprehensive strategy can be enhanced by increasing the involvement of service users and their families in all stages of the rehabilitation process
Republished from ‘Disability World’ web-zine

External evaluation of the community based rehabilitation program (CBR) in Jarash Camp, Amman, Jordan

YASSIR, Samar Al
November 2004

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This in an evaluation of a CBR project started in 1988 in a refugee camp. The general objective of the project is "to reach the biggest number of disabled persons in need of rehabilitation, and that an increased number of disabled persons live independently and are integrated in the society." Strategies include developing capabilities of disabled persons through the services offered by the Community Rehabilitation Centre, mobilization of local resources and awareness raising and advocacy.The evaluators found that the project urgently needs to include PWDs in the running of the project and to adopt a long-term strategy developing PWDs integration and economic autonomy. It also recommends a need for organizational change, improved monitoring and evaluation, staff motivation, and management and planning

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