Community Based Rehabilitation(CBR) Matrix

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Original Editor - Redisha Jakibanjar Top Contributors - Redisha Jakibanjar

What is CBR matrix ?[edit | edit source]

CBR matrix is a framework established in 2004 to create a uniformity in CBR programmes. [1]CBR matrix highlights the different sectors and elements of community to create a CBR strategy. [2]

CBR matrix has five key components which is further divided into 5 elements. The CBR personnel can pick and choose any element or component from the matrix which planning the programme. The matrix should not be viewed as a sequential.[2]

Components of CBR[edit | edit source]

The five components of CBR matrix are: health, education, livelihood, social and empowerment. [1]The following table shows the elements of the matrix along with the components[1]:

Health Education Livelihood Social Empowermeent
Promotion Early childhood Skills development Personnel assistance Advocacy and communication
Prevention Primary Self-employment Relationships, marriage and family Community mobilization
Medical care Secondary and higher Wage employment Culture and arts Political participation
Rehabilitation Non- formal Financial support Recreation, leisure and sports Self-help groups
Assistive devices Lifelong learning Social protection Justice Disabled people's organization

Health[edit | edit source]

Health is one of the most important component of CBR matrix.[3]The main aim of CBR is to help People with disabilities (PWDs) achieve their highest attainable standard of health by addressing the five elements of the health(promotion, prevention, medical care, rehabilitation and assistive devices). CBR personnel also has to work with family members along with the individual to help them to get proper access to health services and ensure that all the aspects of the health are well addressed.[3]

The desirable outcomes for the health are[3]:

  • PWDs and their family members are active participant for achieving sound health and have increased knowledge about the health and health care system.
  • Every health personnel is aware about the right of PWDs toward health and there is no any discrimination based on disability, gender and many other factors.
  • Both PWDs and their family members have close and easy access to health care services in their community in reasonable price.
  • Health and rehabilitation interventions enable PWDs to become active participants in family and community life.
  • There is improved collaboration across all development sectors, including education, livelihood and social sectors, to achieve good health for PWDs.

There are various determinants of health and one should also be aware about the health care provision of the their nation.[3] Besides the disability they are having, PWDs have different barriers to the health-care services. Few of them are[3]:

  • Lack of proper policies and legislation, difficulty implementing the policies and discrimination while providing the service.
  • Limited income of family and economic barriers.
  • Lack of access to transportation and buildings due to geographical and physical barriers.
  • Difficulty with communication among health professionals and access to information.
  • Poor attitudes of health workers about PWDs and lack of knowledge, understanding and skills to manage health issues for PWDs.
  • Lack of knowledge among PWDs about their rights and health issues and available health services.

The five elements of the health are described below.

Health promotion[edit | edit source]

Health promotion of the matrix focuses on the importance of health promotion for PWDs. It guides the CBR programmes to focus on facilitating the access to health promotion activities and implementing basic activities wherever necessary. Health promotion changes the wide range of determinants of health and involves many sectors and not just the health sectors. [3]

The goal of health promotion is to recognize the health potential of PWDs and their families and empower them to enhance/maintain the existing levels of health. [3]

Some of the desirable outcomes of health promotional activities are[3]:

  • Health promotional information provided to PWDs, their family members and members of the general community are same.
  • Health promotion materials and programmes incorporate the special needs of PWDs.
  • PWDs and their families have proper knowledge, skills and support to help them to achieve good level of health.
  • People related to health care system have improved awareness about the general and specific health needs of PWDs and respond to the issues through relevant health promotional activities.
  • Supportive environment is created by the community for PWDs to get enrolled in the activities which enhance their health.
  • CBR programmes value good health and undertake health-promoting activities in the workplace for their staff.

There are various areas for action which can be used to help develop and implement health promotional strategies. The areas of health promotional activities are listed below[4]:

  1. Build healthy public policy
  2. Create supportive environments
  3. Strengthen community actions
  4. Develop personnel skills
  5. Reorient health services

Health prevention[edit | edit source]

Related links[edit | edit source]

References[edit | edit source]

  1. 1.0 1.1 1.2 World Health Organization. Introductory Booklet. Community Based Rehabilitation CBR Guidelines.Switzerland:WHO press;2010.Available from:
  2. 2.0 2.1 World Health Organization. Disability and rehabilitation. Community-based rehabilitation(CBR).Accessed on: 2021/05/07. Available from:
  3. 3.0 3.1 3.2 3.3 3.4 3.5 3.6 3.7 World Health Organization, UNESCO, ILO,IDDC. CBR guidelines2: health component. Geneva: World Health Organization,2010.Available from:
  4. Ottawa Charter for Health Promotion. Geneva, World Health Organization, 1986 ( NPH/docs/ottawa_charter_hp.pdf, accessed 7th May 2021).Available from:,-1986