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To achieve the goal of helping people with disabilities to reach their highest attainable level of health, CBR works across five key areas:
As the view of disability has altered from a purely medical approach to one that recognizes the importance of social and environmental influences on disability, CBR has become a multisectoral approach that works across many sectors, such as education and livelihood.
Because health is such a large topic, this module will focus primarily on CBR activities that take place within the health sector.
Learn about the service provided by an Indian woman who lost her sight.
Thailand has a long and successful history of primary health care. In many provinces, primary health care is based around networks of satellite units called primary care units, which are connected to and supported by large central hospitals.
In 2006, one of these hospitals, Sichon Hospital, introduced CBR to their network of primary care units. The Tha-Hin primary care unit is part of this network. It is located in a rural area and has a team of health personnel including a family doctor, a pharmacist, nurses and health workers. Before CBR was introduced, this team mostly carried out general health promotion and prevention activities. However, with the addition of CBR, the team also became responsible for identifying people with disabilities and addressing their health-care needs.
The major focus of CBR was to provide health services for people with disabilities on their “doorsteps”. Home visits are conducted on a regular basis by members of the Tha-Hin team and a physical therapist from Sichon Hospital, enabling people to avoid unnecessary and costly travel. Local volunteers and family members were also trained to provide basic rehabilitation – dailyliving skills training –to people with disabilities and were encouraged to promote inclusive education for children with disabilities. The multi-disciplinary approach has ensured that all people with disabilities are able to access health care and rehabilitation services in their communities, and be offered referrals to Sichon Hospital when needed.
A 2008 evaluation concluded that CBR had been effective in providing a range of health-care services for people with disabilities and their families, including:
Overall,quality of life has been enhanced for all people with disabilities, with improvements in their independence, mobility and communication skills. Parents of children with disabilities have also been provided with better support. Good working relationships have been established between all key stakeholders; and the inclusion of local volunteers and mobilization of other resources have created a sense of community empowerment and ownership.
