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close this bookSustainable Development and Persons with Disabilities: The Process of Self-Empowerment (ADF, 1995, 117 p.)
close this folderSection I: Understanding and perception
close this folderChapter 4: Community-based rehabilitation
View the document(introduction...)
View the documentPractices in relation to the PWDs
View the documentWhat is CBR?
View the documentCase studies
View the documentA general assessment of CBR: Possibilities and limitations
View the documentAction guidelines

A general assessment of CBR: Possibilities and limitations

At the Entebbe Workshop the issue of CBR generated much discussion. Since many of the participants had hands-on experience with CBR projects in their own countries, they were able to summarise their experience thus:

Positive achievements of CBR

· It has helped create self employment

· It has built up self-confidence and reduced dependence and begging

· It has positively changed the attitude of the community

· It has stimulated development

· It has integrated PWDs into the social and economic development

· It has encouraged funders to support more community based activities.

· It has enabled people with disabilities to display their talents within the society while participating in income generating activities.

· It has utilized locally available resources

· It has helped transfer skills and appropriate technology

· It has created sustainability by developing society's capability.

· It has reached the hitherto unreached.

What then of its limitations?

Most of the limitations arise, the participants suggested, because of the general level of Poverty and literacy in many countries in Africa. Given these, if not properly planned and implemented, CBR could develop several problems. The following are some of these.

· It could turn into a top-down and technicist project.

· Imposing the project on the PWDs (by community leaders, professionals, or the donors) without their active participation and involvement

· CBR may not be the priority of the community and may compete for scarce resources, and this may therefore constrain its viability.

· Many CBR programmes focus on the medical model with emphasis on children's disabilities. The vocational, educational and employment components get neglected.

· Within integrated groups, suspicion may exist among the PWDs that they are being manipulated and used by the non-disabled persons.

· Lack of funding/resources for CBR projects could create problems of sustainability.

· Donor resources can undermine local initiatives and resources.

· Politically motivated projects aimed at securing political support could affect CBR negatively - [e.g. a wheel chair donated to a deaf person by a politician who had no knowledge of the latter's needs.]

· Difficulty of coordination arising out of lack of cooperation from the individual, family or the community.

· Difficulty of sourcing expensive appliances needed to fully integrate the PWDs into integrated projects.

· Duplication of community services by various extension workers from other programmes.

· Insufficient number of adequately trained CBR community workers could lead to poor conception, implementation and supervision of projects.

· CBR is still viewed by many DPOs as a foreign concept, and this has made its acceptance difficult.


In spite of the limitations, CBR, most people agreed, is still the most cost effective approach. It can help facilitate independent living for persons with disabilities drawing on the resources and the support structures of the community. For CBR to be successfully implemented, the following areas of activity and concern have to be built into the CBR-based programmes.

· Vocational training and loan schemes for income generating activities of the PWDs so that CBR projects can be self-sustaining. [The Mawotto project is a good instance of this.]

· Assistive aids need to be procured without straining the resources of the community whilst not creating a dependency syndrome.

· Awareness campaigns within the community can help to avoid top-down and technicist approaches.

· Self-representation by persons with disabilities is an important element in project planning. They should include the severely disabled people or their carets, who are often left out of project planning.

· CBR projects should be backed by affirmative policies and strong legal mechanisms for enforcement.

· As far as possible CBR should be based on the use of local resources, with outside assistance considered as supplementary.