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CBR in AfghanistanJenny WickfordPhD RPT
CBR in Afghanistan
CBR in Afghanistan Different NGOs have been running CBR since early 1990s,
by various different NGOs
CBR in Afghanistan Different NGOs have been running CBR since early 1990s,
by various different NGOs
CBR is implemented in 16 / 34 provinces
CBR in Afghanistan Different NGOs have been running CBR since early 1990s,
by various different NGOs
CBR is implemented in 16 / 34 provinces
Often include service provision (eg physiotherapy and assistive devices) since the government has not been able to do this
CBR in Afghanistan Different NGOs have been running CBR since early 1990s,
by various different NGOs
CBR is implemented in 16 / 34 provinces
Often include service provision (eg physiotherapy and assistive devices) since the government has not been able to do this
Undergoing change – unsure about what will happen in future
CBR in Afghanistan Different NGOs have been running CBR since early 1990s,
by various different NGOs
CBR is implemented in 16 / 34 provinces
Often include service provision (eg physiotherapy and assistive devices) since the government has not been able to do this
Undergoing change – unsure about what will happen in future
Rehabilitation of Afghans with Disabilities (RAD) – largest disability programme in the country
Rehabilitation of Afghans with DisabilitiesGeographical spread
Rehabilitation of Afghans with Disabilities
Rehabilitation of Afghans with Disabilities
5 different components
Special and inclusive education
Information, education, communication
Vocational training and revolving loans
Physiotherapy
Orthopaedic workshops
Physiotherapy component
Physiotherapy component Institution-based services
Physiotherapy component Institution-based services
‘Home-Based Training’
Physiotherapy component Institution-based services
‘Home-Based Training’
Community-based physiotherapy?
Community-based health services?
Goal of CBR in relation to health: that “people with disabilities achieve their highest attainable standard of health” (WHO, CBR Guidelines, Health Component, 2010).
Community-based health services?
Goal of CBR in relation to health: that “people with disabilities achieve their highest attainable standard of health” (WHO, CBR Guidelines, Health Component, 2010).
Thus, what is the role of a physiotherapist, occupational therapist or nurse in a CBR programme? An orthopaedic technician?
Community-based health services?
Goal of CBR in relation to health: that “people with disabilities achieve their highest attainable standard of health” (WHO, CBR Guidelines, Health Component, 2010).
Thus, what is the role of a physiotherapist, occupational therapist or nurse in a CBR programme? An orthopaedic technician?
DISCUSSION
Community-based health services?
Role of CBR in relation to health: “to work closely with the health sector to ensure that the needs of people with disabilities and their family members are addressed in the areas of health promotion, prevention, medical care, rehabilitation and assistive devices. CBR also needs to work with individuals and their families to facilitate their access to health services and to work with other sectors to ensure that all aspects of health are addressed” (WHO, CBR Guidelines, Health Component, 2010).
Community-based health services?
Technical expertise as part of a referral system is essential for CBR programmes to function: “If following the basic assessment, CBR personnel identify a need for specialized rehabilitation services, e.g. physiotherapy, occupational therapy, audiology, speech therapy, they can facilitate access for people with disabilities by initiating referrals” (WHO, CBR Guidelines, 2010)
Community-based health services?
Technical expertise as part of a referral system is essential for CBR programmes to function: “If following the basic assessment, CBR personnel identify a need for specialized rehabilitation services, e.g. physiotherapy, occupational therapy, audiology, speech therapy, they can facilitate access for people with disabilities by initiating referrals” (WHO, CBR Guidelines, 2010)
For eg, physiotherapists with a particular community focus – community or community-based physiotherapists
Require additional skills
Not just home-based treatment! Work with education, advocacy and awareness, lobbying, collaboration with other professionals etc
Community-based health services?
In Afghanistan, physiotherapy and orthopaedic technicians were included by necessity, since these services are not sufficiently available within the national health-care structures.
Community-based health services?
In Afghanistan, physiotherapy and orthopaedic technicians were included by necessity, since these services are not sufficiently available within the national health-care structures.
Present challenge – to shift physiotherapy in national healthcare structures
Salary issues
Technical support challenges
Status
Less recognition of the profession within national healthcare structure
Community-based health services
Present developments 2011
Expanding the training, to specifically train physiotherapists for the national healthcare structure
Adapting the present 3-year curriculum to strengthen referral system and collaboration between relevant health professionals, to strengthen links with communities, and to raise awareness of rehabilitation services
Community-based health services
Present developments 2011
Expanding the training, to specifically train physiotherapists for the national healthcare structure
Adapting the present 3-year curriculum to strengthen referral system and collaboration between relevant health professionals, to strengthen links with communities, and to raise awareness of rehabilitation services
Future possibilities
Institution-based physiotherapists + community physiotherapists
Community-based health services
Present developments 2011
Expanding the training, to specifically train physiotherapists for the national healthcare structure
Adapting the present 3-year curriculum to strengthen referral system and collaboration between relevant health professionals, to strengthen links with communities, and to raise awareness of rehabilitation services
Future possibilities
Institution-based physiotherapists + community physiotherapists
Huge challenge: to move away form dependency on NGOs as services are moved into government structures
tashakor
