[ILO UNESCO WHO] CBR a Strategy for Rehabilita(BookFi.org)

8/12/2019 [ILO UNESCO WHO] CBR a Strategy for Rehabilita(BookFi.org)

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InternationalLabour

Office

CBR

United Nations

Educational, Scientific

and Cultural Organization

World HealthOrganization

A Strategy for

Rehabilitation, Equalization

of Opportunities, Poverty

Reduction and

Social nclusion ofPeople !ith "isabilities

#oint Position Paper $%%&


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WHO Library Cataloguing-in-Publication Data

CBR : a strategy for rehabilitation, equalization of oortunities, o!erty

re"uction an" social inclusion of eole #ith "isabilities : $oint osition aer% &nternational Labour Organization, 'nite" (ations )"ucational, *cientific

an" Cultural Organization an" the Worl" Health Organization+

+Rehabilitation + Disable" ersons .+Co//unity health ser!ices 0+Health

olicy 1+Hu/an rights 2+*ocial $ustice 3+Consu/er articiation 4+Po!erty

&+&nternational Labour Organization &&+'()*CO &&&+Worl" Health Organization+

&*B( 5-0-15.4-5 6(L7 classification: WB .89

Photographs credit : WHO, ILO and Mr. AntonioFiorente.

Worl" Health Organization 880

;ll rights reser!e"+ Publications of the Worl" Health Organization can be obtaine" fro/ 7ar


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&&


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2+ Eurther "e!elo/ent of CBR .2++ )@ansion an" *caling u ofCBR Progra//e .

2+++ =en"er )quality 02+++ &nclusion of ;ll ;ge =rous 0

2++ raining for CBR 12+++ 7anage/ent raining 1

2+++ raining for DPOs 12++.+ raining for *er!ice Deli!ery 2

3+ Conclusion 3

Content

+ &ntro"uction

+ Co//unity Base" Rehabilitation 6CBR9 ++ Concet of CBR ++ 7a$or Ob$ecti!es +.+ )!olution of Concets in CBR .

+.++ Disability an" Rehabilitation .+.++ Hu/an Rights 0+.+.+ Po!erty 0+.+0+ &nclusi!e Co//unities 2+.+1+ Role of Organizations of Persons #ith Disabilities 3

.+ Who &nitiates CBR G 40+ )ssential )le/ents of CBR 50++ (ational Le!el 5

0+++ (ational Policies 80+++ (ational Co-or"ination of CBR 0++.+ 7anage/ent *tructure for CBR 0++0+ ;llocation of Resources 0++1+ (ational *uort

0++ &nter/e"iate%District Le!el 0+++ CBR 7anagers .

0+.+ Co//unity Le!el .0+.++ Recognition of the (ee" for CBR .0+.++ Co//unity &n!ol!e/ent 00+.+.+ Co//unity Wor


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1. Introduction

Co//unity-base" rehabilitation 6CBR9 ro/otes collaborationa/ong co//unity lea"ers, eole #ith "isabilities, their fa/ilies,an" other concerne" citizens to ro!i"e equal oortunities for alleole #ith "isabilities in the co//unity+ he CBR strategy, initi-ate" t#o an" a half "eca"es ago, continues to ro/ote the rightsan" articiation of eole #ith "isabilities an" to strengthen therole of their organizations 6DPOs9 in countries aroun" the #orl"+

&n 550 the &nternational Labour Organization 6&LO9, 'nite"(ations )"ucational *cientific an" Cultural Organization6'()*CO9 an" Worl" Health Organization 6WHO9 ro"uce" aIoint Position Paer on CBRJ in or"er to ro/ote a co//onaroach to the "e!elo/ent of CBR rogra//es+ Desite therogress /a"e since then, /any eole #ith "isabilities still "onot recei!e basic rehabilitation ser!ices an" are not enable" toarticiate equally in e"ucation, training, #or


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C#ces

he urose of this Ioint Position Paer 880 is to "escribe an"suort the concet of CBR as it is e!ol!ing, #ith its e/hasis onhu/an rights an" its call for action against o!erty that affects/any eole #ith "isabilities+

WHO, &LO an" '()*CO !ie# CBR as a strategy that cana""ress the nee"s of eole #ith "isabilities #ithin theirco//unities in all countries+ he strategy continues to ro/oteco//unity lea"er- shi an" the full articiation of eole #ith"isabilities an" their organizations+ &t ro/otes /ulti-sectoral

collaboration to suort co//unity nee"s an" acti!ities, an"collaboration bet#een all grous that can contribute to /eetingits goals+

2. Community Based Rehabilitation (CBR)

2.1 Concept of CBR

CBR is a strategy #ithin general co//unity "e!elo/ent for therehabilitation, equalization of oortunities an" social inclusion ofall eole #ith "isabilities+

BR is i/le/ente" through the co/bine" efforts of eoleith "isabilities the/sel!es, their fa/ilies, organizations an"

o//unities, an" the rele!ant go!ern/ental an" non-go!-rn/ental health, e"ucation, !ocational, social an" otherer!ices+

2.2 Major Objecties

he /a$or ob$ecti!es of CBR are:+ o ensure that eole #ith "isabilities are able to /a@i/ise

their hysical an" /ental abilities, to access regular ser!ices


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an" oortunities, an" to beco/e acti!e contributors to theco//unity an" society at large+

+ o acti!ate co//unities to ro/ote an" rotect the hu/anrights of eole #ith "isabilities through changes #ithin theco//unity, for e@a/le, by re/o!ing barriers to articiation+

2.! "olution of Concepts in CBR

;lthough its "efinition an" /a$or ob$ecti!es ha!e not change",there has been an e!olution of concets #ithin CBR an" of sta


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"isabilities or their a"!ocates /a


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an" rehabilitation, e"ucation, s


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##

s to

2.!.' Inclusie Communities

he ter/ Kinclusi!e is no# co//only use" #ith reference to e"u-cational ro!ision that #elco/es all chil"ren, inclu"ing those #ith"isabilities, to articiate fully in regular co//unity schools orcentres of learning+ he rincile of Kinclusion is also beingalie" to olicies an" ser!ices in health, s


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2.!.( Role of Or%aniations of &ersons*ith #isabilities (#&Os)

o"ay DPOs are reare" to ta


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&t is essential that CBR an" other "isability-relate" rogra//esare lanne" an" i/le/ente" #ith "isable" eole an" theirreresentati!es+ DPOs ha!e the right an" the resonsibility to

i"entify the nee"s of all eole #ith "isabilities to /a


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'. "ssential "lements of CBR

CBR requires co//unity an" DPO in!ol!e/ent+ But co//unitiesan" DPOs cannot #or< alone to ensure equal oortunities foreole #ith "isabilities+ (ational olicies, a /anage/ent struc-ture, an" the suort of "ifferent go!ern/ent /inistries, (=Osan" other sta


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riorities an" lanning of a CBR rogra//e+ (ational le!elco-or"ination an" allocation of a"equate resources are otherele/ents i"entifie" #ith successful CBR rogra//es+

'.1.1 -ational &olicies

he national go!ern/ent is resonsible for the for/ulation ofolicies an" legislation for the rehabilitation, equalization ofoortunities an" the social an" econo/ic inclusion of eole#ith "isabilities+ *uch olicies /ay inclu"e secific reference to

CBR as a strategy+

&nternational instru/ents an" "eclarations rele!ant to "isabilitycan gui"e the for/ulation of national olicies: the '( %tandard&ules on the '(uali)ation of Opportunities for Persons *ith

isa!ilities, the #$ Con+ention on the &ights of the Child6;rticles an" .9, the &LO Con+ention $o./0 concerningthe 1ocational &eha!ilitation and 'plo"ent of isa!led

Persons an" the associate" Reco//en"ation (o+ 24, the'()*CO %alaanca %tateent and Frae*or2 for Action

3'ducation for All, on *ecial (ee"s )"ucation, the WHOeclaration of Ala4Ata establishing rehabilitati!e care as art ofri/ary health care, an" the 5ei6ing Platfor for Action for the

Ad+anceent of Woen 6aragrahs 28, 4, 31, 34, .9+

(ational olicies /ay also ta


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'.1.2 -ational Co/ordination of CBR

7any countries ha!e foun" that a national le!el co-or"inatingbo"y is necessary to ensure the /ulti-sectoral collaborationnee"e" for an effecti!e CBR rogra//e+ he /echanis/ forco-or"ination #ill !ary "een"ing on the aroach referre" bygo!ern/ent+ here /ay be, for e@a/le, a national co-or"inatingco//ittee consisting of reresentati!es fro/ the !arious /inis-tries that collaborate to suort CBR? or one /inistry /ay ta


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&t is !ery i/ortant for all /inistries, as #ell as non-go!ern/entalorganizations to #or< in artnershi+ ;lthough one /inistryro!i"es the organizational structure, all sectors lay an i/ortantrole in ensuring that co//unities articiating in the CBRrogra//e ha!e access to suort ser!ices an" resources+

'.1.' llocation of Resources

(ational resources can be allocate" to CBR in a !ariety of #ays+One is the "irect allocation of fun"s to suort asects of the

CBR rogra//e, such as training or the strengthening of suortser!ices+ ;nother /etho" is to inclu"e a "isability co/onent inall "e!elo/ental rogra//esinitiati!es esecially in ai/e" ato!erty re"uction strategy rogra//es+ =o!ern/ent can alsoencourage (=Os, businesses an" the /e"ia to suort CBR+

'.1.( CBR &ro%rammes *ithout -ational 0upport

; CBR rogra//e #ith strong lin


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'.2.1 CBR Mana%ers

CBR rogra//e /anagers usually #or< in the /inistry thatro!i"es the organizational fra/e#or< for the rogra//e+ Eore@a/le, if the /inistry for social affairs is in charge of CBR,social #elfare officers #ill robably ha!e CBR as one co/onentof their #or


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teceo

!olun

'.!.2 Community Inolement

&f the co//unity "eci"es to a""ress the nee"s of eole #ith"isabilities, the rocess of establishing a CBR rogra//e canbegin+ One aroach to i/le/enting CBR is through the lea"er-shi of an e@isting co//unity "e!elo/ent co//ittee or otherstructure hea"e" by the chief of the !illage or the /ayor of theto#n+ his co//ittee gui"es the "e!elo/ent acti!ities of theco//unity+ *uch a co//ittee is #ell suite" to act as co-or"ina-tor of the /any sectors, go!ern/ental an" non-go!ern/ental,

hat /ust collaborate to sustain a CBR rogra//e+ Eor@a/le, the co//unity "e!elo/ent co//ittee canollaborate #ith the e"ucational sector to ro/ote inclusi!e"ucation, #ith the /inistry of transort to "e!elo a syste/f accessible transort for eole #ith "isabilities, an" #ithtary organizations to for/ a grou of !olunteers #illing to

ta


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sharing infor/ation about suort ser!ices for eole #ith"isabilities that are a!ailable outsi"e the co//unity? #or


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1


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CBR #or


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bet#een go!ern/ent /inistries, collaboration is nee"e" bet#eenthese /inistries, non-go!ern/ental organizations an" the ri!atesector+ &t is nee"e" bet#een the co//unity an" the referralser!ices at local an" inter/e"iate le!els, an" also bet#een the!arious referral ser!ices at local, inter/e"iate an" national le!els+Collaboration bet#een national, inter/e"iate an" co//unityle!els #ithin a sector can ensure that aroriate referralser!ices are "e!eloe" an" "eli!ere"+

(.1 0upport from the 0ocial 0ector

;lthough the allocation of resonsibility for social affairs !ariesfro/ country to country, /atters co//only a""resse" inclu"e"isability ensions, technical ai"s an" a"atations, housing,!ocational training an" e/loy/ent, an" co-or"ination of referralsfor in"i!i"uals #ho require ser!ices fro/ other sectors+ &f thesocial affairs /inistry initiates CBR, social #elfare officers /ay be

/anagers of the rogra//e+

; /inistry for social affairs /ay not ha!e ersonnel at local le!el,but it is co//on that ersonnel oste" at "istrict%inter/e"iatele!el are fa/iliar #ith social an" econo/ic con"itions an"


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tParo

eo

(.2 0upport from the $ealth 0ector

he Worl" Health Organization 6WHO9 "efines health as a stateof co/lete hysical, /ental an" social #ell-being an" not/erely the absence of "isease or infir/ityJ+ he eclaration of

Ala Ata 65349 states that Pri/ary Health Care 6PHC9 is the


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rehabilitation ser!ices /ust collaborate #ith all the other ser!ices#ithin the health care syste/+ &t is also necessary to collaborate#ith the sectors for e"ucation, labour an" social affairs to ensureequal citizenshi for eole #ith "isabilities+

(.! 0upport from the "ducational 0ector

=oo" co-oeration bet#een co//unities an" the e"ucation sec-tor is i/erati!e if the goals of 'ducation for All are to be /et+

With /ore than 58 er cent of chil"ren #ith "isabilities in "e!el-oing countries not atten"ing school, it is e!i"ent that stes /ustbe ta


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inclusi!e schools - oen to all chil"ren - ha!e their rightful lace+Chil"ren #ith /ultile or se!ere "isabilities #ho require e@tensi!ea""itional suort /ay be taught #ithin secial units, "een"ingon the e@isting le!el of e@ternal suort being ro!i"e"+ *ecialschools are i/ortant artners in the school syste/ an" /ay beuse" as a resource for regular schools in ro/oting inclusi!ee"u- cation+

o ro/ote 'ducation for All, the e"ucational sector shoul" a"atthe initial an" in-ser!ice training of both regular an" secialise"

teachers in resonse to the ne# roles in the inclusi!e school, as#ell as ensure that classroo/s, facilities an" e"ucational /ateri-als are accessible+ he e"ucation sector /ust ta


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ro!i"ing !ocational rehabilitation ser!ices, !ocational gui"ancean" s


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to eole #ith "isabilities, #hile others can /a


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to pa" for one, the social *elfare officer re(uests assistance fro,other sectors, including $-Os.

he suort ser!ice that consi"ers the holistic nee"s of the er-son, an" not $ust the focus of its o#n ser!ice, is /ore li


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(e# settings /ay also inclu"e locations #here the co//unity isnot #ell "e!eloe", such as refugee ca/s+ )!en in these set-tings, co//unity lea"ers /ay be i"entifie" an" encourage" to/a


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ities, inclu"ing those #ith chronic con"itions such as heart"isease, "iabetes or H&F+ Peole #ith "isabilities in /i""le age/ay #ish to continue #or


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5.2.! :rainin% for 0erice #eliery

#o grous of eole are in!ol!e" in ser!ice "eli!ery: theco//u- nity CBR #or


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6. Conclusion

CBR is an effecti!e strategy for increasing co//unity le!elacti!ity for equalization of oortunities for eole #ith "isabilitiesby inclu"ing the/ in rogra//es focuse" on hu/an rights,o!erty re"uction an" inclusion+

he WHO, &LO an" '()*CO e/hasise the i/ortance of thearticiation of eole #ith "isabilities in the lanning an"i/le/enting of CBR rogra//es, the necessity of increase"

collaboration bet#een sectors that ro!i"e the ser!ices use" byeole #ith "isabilities, an" the nee" for go!ern/ent suort an"national olicies on CBR+

;ll countries an" sectors are in!ite" to :

M ;"ot Co//unity-Base" Rehabilitation as a olicy an"strategy rele!ant to hu/an rights an" o!erty re"uction for

eole #ith "isabilities?

M Pro!i"e suort for nation-#i"e CBR rogra//es?

M Create the con"itions for /ulti-sectoral collaboration toa"!ance CBR #ithin co//unity "e!elo/ent+

[ILO UNESCO WHO] CBR a Strategy for Rehabilita(BookFi.org)

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