Community Based Rehabilitation(CBR) Matrix

Original Editor - Redisha Jakibanjar Top Contributors - Redisha Jakibanjar, Kim Jackson and Naomi O'Reilly

What is Community Based Rehabilitation 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 five elements. The CBR personnel can pick and choose any element or component from the matrix when planning the programme. The matrix should not be viewed as a sequential.[2]

Components of Community Based Rehabilitation[edit | edit source]

The five components of CBR matrix are: health, education, livelihood, social and empowerment. [1]The following table shows the components of the matrix along with it's element[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 has to work with family members along with the individual to help them get proper access to health services and ensure that all the aspects of the health are well addressed.[3]

The desirable outcomes of the CBR program focused on the health component 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 focuses on the importance of health promotion for PWDs by 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 CBR program with health promotion as main element 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]

There are three level of health prevention: Primary, secondary and tertiary.

Primary Health Prevention[edit | edit source]

Primary health prevention focuses primarily on prevention. It is directed at avoidance and using interventions like immunization, nutrition, changing behaviors, providing safe water supplies, sanitation and good living that prevent health conditions form occurring. [3]

Secondary Health Prevention[edit | edit source]

Secondary health prevention focuses on early detection and early treatment of health conditions. Some of the examples are: early detection of breast cancer using mammograms, eye examinations, multidrug treatment of leprosy to prevent disease progression and appropriate handling of fractured bone to promote proper healing and prevention of deformity.[3]

Tertiary Health Prevention[edit | edit source]

Tertiary health prevention focuses on limiting and reversing the impact of already existing health conditions and impairments. It includes rehabilitation services and interventions that aim to prevent activity limitations. [3]

The main goal of health prevention is to prevent PWDs from developing health conditions related or unrelated to their impairments that affect their quality of life.[3]

The desired outcome of CBR programme focused on health prevention are[3]:

  • Persons with Disabilities and their families have proper information and services aimed at health prevention.
  • Persons with Disabilities and their families adopt the healthy behavior and lifestyle to reduce the risk of developing health problems.
  • Persons with Disabilities are included and participate in primary prevention activities, e.g. immunization programmes, to reduce their risk of developing additional health conditions or impairments.
  • All community members participate in primary prevention activities, e.g. immunization programmes, to reduce their risk of developing health conditions or impairments which can lead to disability.
  • CBR programmes collaborate with the health and other sectors, e.g. education, to address health issues and provide support and assistance for prevention activities.

Medical care[edit | edit source]

The goal of this element is to provide proper access to medical care both general and specialized based on their individual needs. The desired outcome of program with medical care as core element are[3]:

  • CBR personnel have adequate knowledge about medical care services and referral for general or specialized medical care.
  • Persons with Disabilities and their families have access to services(screening and diagnostic) that focuses on early identification of health conditions and impairments.
  • Establishment of inclusive medical care service and have improved access for PWDs.
  • Persons with Disabilities have access to surgical care for impairment correction and minimization.
  • Persons with Disabilities and their families develop self-management skills whereby they are able to ask questions, discuss treatment options, make informed decisions about medical care and manage their health conditions.
  • Medical care personnel have increased awareness regarding the medical needs of Persons with Disabilities, respect their rights and dignity and provide quality services.

There are three types of medical care: primary, secondary and tertiary.

Primary Care[edit | edit source]

Primary care is the basic health care provided at the community level and is usually provided through health centers or clinics. Primary medical care includes treatments for acute conditions (e.g. infections) and routine management of chronic conditions(e.g. leprosy, epilepsy, tuberculosis, diabetes). [3]

Secondary Care[edit | edit source]

This type of care is provided by large clinics or hospitals which are usually present at the district level. Primary health care provides an important link to secondary care through referral mechanisms.[3]

Tertiary Care[edit | edit source]

This is highly specialized medical care which is provided by specialized medical professionals in association with nurses and paramedical staff and involves the use of specialized technology. These services are provided by large hospitals in major cities at the national or regional level. Medical care provided at the tertiary level might include brain surgery, cancer care or orthopaedic surgery.[3]

Rehabilitation[edit | edit source]

The goal of CBR program centered to this element is to provide access to Persons with Disabilities to rehabilitation services for uplifting their overall well-being, inclusion and participation.[3]

The desirable outcome of rehabilitation as a CBR program are[3]:

  • Persons with Disabilities receive individualized assessments and are involved in the decision making for interventions provided in rehabilitation.
  • Persons with Disabilities and their family members are aware about the role and purpose of rehabilitation and receive accurate information about the services available within the health sector.
  • Persons with Disabilities are referred to specialized rehabilitation services and are provided with follow-up to ensure that these services are received and meet their needs.
  • Basic rehabilitation services are available at the community level.
  • All the required materials are available for CBR personnel, Persons with Disabilities and families to support rehabilitation activities.
  • Appropriate training, education and support are received to enable them to undertake rehabilitation activities.

Assistive Devices[edit | edit source]

Cane length.jpg

The main goal of CBR program directed to assistive device as it's element is to provide access to Persons with Disabilities for appropriate assistive devices that are of good quality and enable them to participate in social and personnel life.[3]

The desirable outcome of the CBR programme focused on this element are[3]:

  • CBR personnel have proper knowledge about the types of assistive devices available, functionality and suitability according to the disability and referral mechanisms for specialized devices.
  • Persons with Disabilities and their families are aware about the types and function of the assistive devices and make informed decisions to access and use them.
  • Persons with Disabilities and their families are provided with training, education and follow-up to make sure that they use and care for their assistive devices appropriately.
  • Local people, including Persons with Disabilities and their families, are able to fabricate basic assistive devices and undertake simple repairs and maintenance.
  • Barriers preventing access to assistive devices, such as inadequate information, financial constraints and centralized service provision, are reduced.
  • Environmental factors are addressed to enable individuals to use their assistive devices in all locations where they are needed.

Education[edit | edit source]

Education starts from the birth and is broader than just school. Every human has the right to education and Persons with Disabilities should not be excluded from this. The main goal of the CBR program is to provide Persons with Disabilities access to education and lifelong learning, leading to fulfilment of potential, a sense of dignity and self-worth, and effective participation in society. [6]The desirable outcome of the CBR program directed to education are[6]:

  • All Persons with Disabilities have access to learn and all the needed resources are available.
  • Inclusive education system is implemented in local schools so that children with disability can also play alongside their friends.
  • Local schools have process access to trained teachers, supportive environment, good links with families and community and resources to maintain proper hygiene and welcoming environment.
  • Persons with Disabilities are involved in education as a role models, decision makers and contributors.
  • Home environments are favorable and encouraging for learning.
  • Communities are aware that Persons with Disabilities have right to learn and provide support and encouragement.
  • There is good collaboration between the health, education, social and other sectors.
  • There is systematic advocacy at all levels to make national policies comprehensive to facilitate inclusive education

The five elements of education are described below:

Early Childhood Care and Education[edit | edit source]

children playing together

Early childhood is the period from birth to eight years and early childhood care and education is the main seed for the inclusive society as children with and without disability get to play and learn together. The main goal of this element is that all children with disabilities have the best possible start in life and are supported throughout their development in inclusive learning environments. [6]

The desired outcome of the CBR program focused on early childhood care and education are[6]:

  • All children have an increased chance of survival and good health.
  • All the children are developed to their maximum potential in physical, social, language and cognitive skills.
  • Inclusive and welcoming environment for all children to access formal and non-formal early childhood education.
  • Children with disabilities and the people who assist them are part of the family and community and have appropriate support.
  • Children learn to play together, accept the differences between them and help each other.
  • The impact of impairments is reduced and compensated for.
  • Children with disabilities make a smooth transition to primary schooling together with their peers.

Primary Education[edit | edit source]

Primary education usually begins from age of six or seven years old and continues into the early teens. Achieving universal primary education is the second of the Millennium Development Goals. So, the goal of CBR program is to create a welcoming, inclusive primary education system in local schools within the community.[6]

The desirable outcome of the CBR program are[6]:

  • The whole community is working to develop inclusive primary education.
  • Families create supportive and positive environment for inclusive primary education.
  • Every children with disability complete a quality primary education.
  • All the assistive devices, interventions and other necessary assistance are provided so that children with disability can participate in inclusive education.
  • Proper assessment and identification of issues related to access within school environment is done and those are addressed.
  • Teachers who educate children with disabilities are confident and are made to feel supported.
  • Every activity should be child-focused and inclusive like: Curricula, examination and assessment systems, teaching approaches and extracurricular activities (e.g. sports, music, clubs).
  • Appropriate Local and specialist resources for education are provided and they are fully and appropriately utilized.
  • Disabled children from poor families attend primary school.
  • To ensure national policies promote inclusive primary education, needed partnerships are created with stakeholders and proper advocacy at all level is also done.

Secondary and Higher Education[edit | edit source]

The main role of CBR program focused on secondary and higher education is to facilitate the inclusive education, increase participation of disabled children and work with the local authorities and school to create accessible environment and flexible curriculum.[6]

The desirable outcome of the CBR program focused on this element are[6]:

  • Increased enrolment, retention and completion in secondary and higher education by students with disabilities.
  • Government grants, scholarships and other sources of funding are provided to students with disabilities and parents and communities have knowledge and skills to access these kind of support.
  • Communities support lobbying groups and campaigns for equal access to education.
  • Families and communities encourage their children, including children with disabilities, to pursue secondary and higher education.
  • Secondary and higher education programmes are accessible and inclusive in terms of environment, teaching methods, curricula, extracurricular activities (e.g. sports, recreation, music) and assessment and examination systems.
  • Secondary schools learn about diversity and inclusion from the experiences of people with disabilities, and develop skills needed for an inclusive society.
  • Specialist resources and support are used correctly to enhance the inclusion of students with disabilities.
  • Transitions between secondary/higher education programmes and into adult life are well supported and career guidance is accessible and inclusive.

Non-formal Education[edit | edit source]

The main goal of CBR program focused on non-formal education is to develop knowledge and skill in PWDs and improve their quality of life(QOL). PWDs should get access to educational opportunities that suit their own need and interest in inclusive setting.[6]


The desirable outcome of the CBR program with non-formal education as a key element are[6]:

  • PWDs participate in non-formal education programmes and learn skills that contribute to their better living conditions.
  • PWDs actively participate in planning and execution of non-formal education.
  • PWDs, family members, disabled people’s organizations and parents’ associations play vital role in decision-making and implementing non-formal education programmes.
  • Home-based learning is available either as a supplement to formal schooling, or in preparation for formal schooling, or as an alternative to formal schooling.
  • Students with disabilities and non-disabled students interact together and develop friendships which help to strengthen the social cohesion.

Lifelong Learning[edit | edit source]

The main goal of lifelong learning is to provide access to PWDs for lifelong learning opportunities and variety of learning experiences. The opportunity of lifelong learning will help to prevent social exclusion, marginalization and unemployment of PWDs.[6]

The desirable outcome of CBR program directed to this element are[6]:

  • Favorable environment is created during formal schooling to Youth with disabilities for learning skills and are helped in their transition to the world of work through vocational and careers guidance and peer counselling services.
  • Adults with disabilities have access to appropriate, flexible and effective learning opportunities throughout life, for example adult literacy through open schools and higher education through distance learning.
  • Individuals and groups who have special needs, such as youth and adults with significant and multiple impairments as well as their caregivers and family members, have access to ongoing learning opportunities.
  • Education related to life skills and survival needs including knowledge about reproductive health, sexuality and Human Immunodeficiency Virus (HIV) are provided to youths and adults with disabilities.
  • Every educational institute in community promote social inclusion of youth and adults with disabilities by providing lifelong opportunities.

Livelihood[edit | edit source]

The goal of CBR program pointed to livelihood is that PWDs gain a livelihood, can easily access social protection measures and are able to contribute to their families and communities economically.[8]

The desirable outcome of the CBR program are[8]:

  • Skills development and lifelong learning opportunities are provided to PWDs.
  • Parents of children with disabilities advocate for access to education, skills acquisition and work opportunities for their children.
  • Discrimination free and non-exploitative environment is created to seek work opportunities for PWDs.
  • Both gender are given equal opportunities for work and employment without bias.
  • Families of PWDs, especially children and people with severe disabilities, have access to better means of livelihood.
  • PWDs and their family members are involved and benefited with all the poverty reduction strategies and programmes .
  • Community members and employers value the work of PWDs.
  • Access to work for PWDs is improved via local authorities by adopting and applying different policies.
  • PWDs have access to social protection measures as a right.

The video shown below depicts and example of how the access to livelihood change the life of PWDs:


The five elements of livelihood are described below:

Skills Development[edit | edit source]

PWDS lack the skills due to lack of support form family, community and lack of access to basic education needed for the skill training. The main goal of CBR program focused on this element is to provide proper knowledge, attitudes and skills to PWDs on basis of their need. [8]

The desirable outcome of the skills development program are[8]:

  • Various training opportunities, skills and decent work are provided to Youth and adults with disabilities so that they have access to income.
  • There is discrimination free environment for creating opportunities to PWDs of both gender.
  • Mainstream providers of vocational and skills training have policies and practices that makes sure that PWDs have access to the training provided.
  • PWDs have access to support services – vocational guidance, placement services, assistive devices and adapted equipment.
  • Advanced skills development opportunities that will help to grow PWDs in their work is provided.

Self-employment[edit | edit source]

Self- employment program will allow PWDs to improve their livelihood, improve their standard of living and contribute to the well-being of their families and communities. The CBR program encourages and supports self employment through enhancing access to skills development as well as financial and material resources. [8]

The desirable outcome of the self-employment program are[8]:

  • PWDs choose their own economic activities to do either in group or individually to earn income.
  • The policies and practices about training and assistance made by mainstream government and non governmental small-enterprise development programmes include provision for PWDs.
  • People with disabilities have access to support services – basic business skills training, business development and financial services – to initiate or expand entrepreneurial activities.
  • Access to business skills development opportunities is provided to PWDs so that they can progress in their economic activities.
  • PWDs are recognized as successful entrepreneurs and productive, contributing members of the community.
  • PWDs promote economic activities and become positive-role model and influencer which contribute to the development of inclusive communities.
  • Especially women with disability have control over the money they earn.
  • Successful entrepreneurs with disabilities act as trainers of other PWDs.

Wage Employment[edit | edit source]

Wage employment provide equal access to earning for PWDs. CBR program help PWDs to have access to services that lead to wage employment, access and retain wage employment.[8]

The desirable outcome of wage employment program are[8]:

  • PWDs earn through wage employment in the formal or informal economy.
  • Inclusive and accessible environment is created at work when employers hire and retain PWDs.
  • Coworkers and management develop greater understanding of disability issues and positive attitudes.
  • PWDs are included in mainstream job services both in private and public sectors.
  • Wage employment help PWDs to increase their self-esteem, personal security and status within their family and community.
  • Through wage employment, PWDs contribute to community life and the economy.

Financial Services[edit | edit source]

Financial services provided to PWDs and their families support the development of their economic and other activities which will ultimately improve their standard of living. CBR program identify, facilitate and promote access of PWDs to financial services. [8] The desirable outcome of financial services program of CBR matrix are[8]:

  • Based on poverty criteria, government or private institutions provide grants, loans and other financial assistance and PWDs have access to those facilities.
  • The financial services provided to PWDs enable them to meet their needs and start small business to earn an income.
  • PWDs, especially women are capable of managing and have control over the financial resources.
  • PWDs are included when financial service providers adapt their rules, services and environment.

Social Protection[edit | edit source]

The main goal of CBR program focused on social protection is to allow PWDS who are out of work, who are unable to work or who have difficulty maintaining their livelihood to enjoy a minimum standard of living through social protection measures. The CBR program facilitates the access of PWDs to mainstream or specific social benefits and promote the provision of social protection measures. [8]

The desirable outcome of social protection CBR program are[8]:

  • Social security measures are provided against loss of income through old age, sickness or disability to PWDs as other citizens without any discrimination.
  • Social protection measures are available to all PWDs who are out of work, earn too little for a decent living or have difficulty working.
  • Existing social services providers are sensitized and aware of the specific difficulties faced by PWDs and adapt their service provision accordingly.
  • Social security providers develop partnerships with PWDs, through their representative organizations and service providers, to adapt practices to their specific needs.

Social[edit | edit source]

PWDs face many barriers and less opportunities while participating in social activities. The goal of the CBR program focused on this component is that PWDs have meaningful social roles and responsibilities in community and family, and they are viewed as equal members of society. [10]

The desirable outcome of the CBR program focused on this component are[10]:

  • PWDs have various social roles and responsibilities and they are valued as equal member of their family.
  • The skills and resources contributed by PWDs and their families to the development of their communities are supported and encouraged to do better.
  • Communities recognize that PWDs can make positive effect in the community and are valued members.
  • The barriers faced by PWDs and their families while participating in social roles and activities are identified and addressed.
  • The needs of PWDs ad their family members are identified and responded by local government authorities and wherever required, effective social support and services are provided.

The five elements of this component are described below.

Personal Assistance[edit | edit source]

The CBR program focused on personal assistance is to enable PWDs to lead active and fulfilling lives by providing access to personal assistance according to their needs. Proper personal assistance help PWDs to live with self-determination and dignity. [10] The desirable outcome of the CBR program focused on personal assistance are[10]:

  • To ensure quality of personal assistance options in the local community, CBR programmes and disabled people's organizations work together.
  • PWDs have individual support plans in place.
  • PWDs have proper training and access to manage their personal assistance needs.
  • Training is available for both informal (family and friends) and formal(social services, private employees) personal assistants.
  • Those who provide informal personal assistance are supported.
  • Family and community are trained and all the mechanisms are ready and in place to respond to crisis situations and prevent PWDs being sent into institutional care.
  • Local communities support and provide community-based personal assistance options for PWDs.

Relationships, Marriage and Family[edit | edit source]

Relationships, marriage and family are the main component of the community. The goal of the CBR program focused on this element is to make PWDs realize their positions and roles within their families and communities to create the fulfilling relationships with members of their families and communities. [10]

The desirable outcome of the CBR program focused on relationships, marriage and family are[10]:

  • People in the community have knowledge, are aware and accept that PWDs can have meaningful relationships, marry and have children.
  • Appropriate services and programmes to support parenting roles are accessible to parents with disabilities and parents of PWDs.
  • Families encourage and support their members with disabilities to socialize and develop relationships outside the home.
  • All the relevant stakeholders work together to address the issue of protection for PWDs and PWDs are protected against violence.
  • PWDs who have limited social networks are well supported in their communities.

Culture and Arts[edit | edit source]

The CBR program focused on this element work to enable PWDs to contribute and participate in the cultural and artistic lives of the family and community they belong.[10]

The desirable outcome of CBR program focused on this element are[10]:

  • Through culture and art, stigma and discrimination that is present in community towards disability is challenged and addressed.
  • PWDs and their family members actively participate in various cultural and arts events and activities.
  • Mainstream organizations and groups support the inclusion of PWDs in their cultural and artistic programmes and activities.
  • PWDs have access to mainstream cultural/arts media and venues.
  • Spiritual and religious leaders and groups include PWDs in their activities.

Recreation, Leisure and Sports[edit | edit source]

Active participation of PWDs in recreation, leisure and sports improve their health and well-being of individuals, contribute to the empowerment of individuals and promote the development of inclusive communities. CBR program focused on this element promote and support increased participation of PWDs in recreation, leisure and sports activities; and provide support to mainstream organizations and programmes to enable them to strengthen their capacity by offering appropriate and accessible recreation, leisure and sports activities.[10]

The desirable outcome of the CBR program whose main element is recreation, leisure and sports are[10]:

  • PWDs actively participate in available recreation, leisure and sports programmes in the local community.
  • PWDs are also included in recreation, leisure and sports programmes organized by local, national and international authorities and associations.
  • The right and ability of PWDs to participate in recreation, leisure and sports activities are well recognized and promoted by families, teachers and community members.
  • People both with and without disabilities are involved together in recreation, leisure and sports activities.
  • The venue for recreation, leisure and sports activities are accessible to PWDs.
  • Equipment used for recreation, leisure and sports is adapted where needed to accommodate the needs of PWDs.
  • Recreational, leisure and sports programmes and activities are developed specifically for PWDs where required.

Justice[edit | edit source]

The CBR program focused on this element make sure that PWDs have access to justice on and equal basis with others. The program promotes and provides support to PWDs and their family members to access justice where they face discrimination and exclusion.[10]

The desirable outcome of the CBR program with justice as main element are[10]:

  • CBR programmes are able to support PWDs to access justice when needed.
  • PWDs have proper knowledge and aware about their right and choices and process needed for accessing justice.
  • Relevant stakeholders in the justice sector are sensitive to the needs of PWDs and follow non-discriminatory practices.
  • PWDs are able to access informal mechanisms (can be accessed through religious and development organizations, village leaders, tribal leaders, social workers, educational and health professionals) of justice when their rights are violated.
  • PWDs are able to access formal mechanisms (can be accessed through court) of justice when their rights are violated

Empowerment[edit | edit source]

Empowerment is the final component of CBR matrix and is different than other component. Other four components focus on the key development sectors while this component focuses on the importance of empowering PWDs, their family members and communities to facilitate the mainstreaming of disability across each sector and to ensure that everybody is able to access their rights and entitlements.[11]

The desirable outcome of the CBR program focused on empowerment component are[11] :

  • PWDs are able to make informed choices and decisions.
  • PWDs actively participate and contribute in their families and communities.
  • PWDs are viewed and accepted as people with potential and the barriers for empowerment in community are removed.
  • Development benefits and services available in the community are accessible to PWDs and their families.
  • PWDs and their family come together, form self help groups and organizations and work together to address their common problem.

The five elements of empowerment are described below

Advocacy and Communication[edit | edit source]

Self advocacy and communication is a vital element for PWDs. The main goal of this element(advocacy and communication) is to enable PWDs to speak out for themselves. CBR program help PWDs to develop advocacy and communication skills and help create favorable environment for opportunities to allow them to make decisions and express their needs and desires in effective way.[11]

The desirable outcome of the CBR program focused on advocacy and communication are[11]:

  • Improved access to information and communication resources are available to PWDs and their families.
  • Barriers in communication faced by PWDs are reduced and/or eliminated.
  • PWDs and their families represent themselves in their respective communities.
  • CBR personnel are effective communicators and share information with all stakeholders including those who have communication difficulties.

Community Mobilization[edit | edit source]

When different people from different parts of the community share a common goal and actively participate in specific program, a lot can be achieved. Community mobilization is the process of bringing together as many stakeholders as possible to achieve the goal of the program.[11]

The main goal of community mobilization is to empower local community members to remove the challenges for PWDs and their families, and play an active role in creating inclusive community. There are four steps of community mobilization for sustainability and self-reliance[11]:

  1. Bringing people together
  2. Raise people's awareness
  3. Assist in delivery of resources and services
  4. Facilitate and strengthen community participation

The desirable outcome of community mobilization are[11]:

  • Communities are aware about the needs, and motivated to improve the quality of life of PWDs and their family members.
  • The barriers faced by PWDs and their families are reduced or removed.
  • Communities are knowledgeable about CBR and how community resources can be used to develop and sustain CBR programmes.
  • Communities participate in planning, implementing and managing CBR programmes.

Political Participation[edit | edit source]

The main goal of the element political participation is to enable PWDs to participate in political and public life on an equal basis with others. CBR program ensures that PWDs and their families have adequate knowledge, information, skills and information about political participation and the opportunities for participation are also accessible to them. The program also works to make issues of disability visible so that PWDs are integrated into political decision-making and are at the center of development policies and programmes. [11]

The desirable outcome of the CBR program focused on political participation are[11]:

  • CBR personnel are aware about the political system.
  • PWDs and their family members are aware about the political participation.
  • Governments and civil society are aware of disability issues and the rights of PWDs and their families to participate in political processes.
  • Challenges faced by PWDs in political processes are minimized or removed.

Self-help Groups[edit | edit source]

CBR program focused on this element provides assistance and support to PWDs and their families to form new self-help groups or support the existing ones. The main goal of creating self-help groups is that PWDs and their family members are able to resolve common problems in group, improve their individual strength and quality of life.[11]

The desirable outcome of this element are[11]:

  • There are self-help groups in local communities for PWDs and their family members.
  • Self-help group members develop knowledge and skills that help them to become contributors in their families and communities.
  • Self-help groups that are available to other member of the community are also accessible to PWDs and their family members.
  • Self-help groups promote CBR, and members become involved in the planning and implementation of CBR programmes.
  • Self-help groups join together to form federations and become self-sufficient.

Disabled Person's Organizations[edit | edit source]

Both CBR programmes and disabled person's organizations focuses on ensuring the implementation of the Convention on the Rights of PWDs and community-based inclusive development. The role of CBR is to work in partnership with disabled people’s organizations where they exist, and where they do not exist, to provide assistance when requested to support their formation.[11]

The desirable outcome of the program focused on this element are[11]:

  • CBR programmes and disabled people’s organizations work together to plan, implement and monitor new or existing CBR programmes.
  • Disabled person’s organizations support CBR programmes to become more representative and inclusive of PWDs.
  • Disabled person’s organizations are motivated to develop and implement CBR programmes in communities where they do not exist.

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. 3.00 3.01 3.02 3.03 3.04 3.05 3.06 3.07 3.08 3.09 3.10 3.11 3.12 3.13 3.14 3.15 3.16 3.17 3.18 3.19 3.20 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 (, accessed 7th May 2021).Available from:,-1986
  5. Let's Learn Public Health. An Introduction to Health Promotion and the Ottawa charter. Available from: [last accessed 5/29/2021]
  6. 6.00 6.01 6.02 6.03 6.04 6.05 6.06 6.07 6.08 6.09 6.10 6.11 World Health Organization, UNESCO, ILO,IDDC. CBR guidelines 3: education component. Geneva: World Health Organization,2010.Available from:
  7. YOUTRAIN video project. What is Non-Formal Education? 7 principles of NFE. Available from: [last accessed 5/29/2021]
  8. 8.00 8.01 8.02 8.03 8.04 8.05 8.06 8.07 8.08 8.09 8.10 8.11 World Health Organization, UNESCO, ILO,IDDC. CBR guidelines 4: livelihood component. Geneva: World Health Organization,2010.Available from:
  9. Leonard Cheshire Disability. Access to livelihoods opportunities for people with disabilities. Available from: [last accessed 5/31/2021]
  10. 10.00 10.01 10.02 10.03 10.04 10.05 10.06 10.07 10.08 10.09 10.10 10.11 World Health Organization, UNESCO, ILO,IDDC. CBR guidelines 5: Social component. Geneva: World Health Organization,2010.Available from:
  11. 11.00 11.01 11.02 11.03 11.04 11.05 11.06 11.07 11.08 11.09 11.10 11.11 11.12 World Health Organization, UNESCO, ILO,IDDC. CBR guidelines 6: empowerment component. Geneva: World Health Organization,2010.Available from: