2012 autumn -- 429 U0210 Topics in Community-based Practice of Occupational Therapy

Community-Based Practice: Definition, Historical Perspective, and Occupational Therapy Roles

By Hui-Fen Mao 2012/9/13

1. What is community-based rehabilitation (CBR)? (http://www.who.int/disabilities/cbr/en/) (WHO Library Cataloguing-in –Publication data)

CBR: a strategy for rehabilitation, equalization of opportunities, poverty reduction and social inclusion of people with disabilities. (2004, Joint Position Paper/International Labour Organization,

United Nations Educational, Scientific and Cultural Organization and the WHO)

CBR: implanted through the combined efforts of people with disabilities themselves, their families, organizations and communities, and the relevant governmental and non-governmental health, education, vocational, social and other services.

CBR, currently in practice in more than 90 countries around the world, is a comprehensive strategy for involving people with disabilities in the development of their communities.

2. What is the objective of CBR ?

1) CBR seeks to ensure that people with disabilities (PWD) have equal access to rehabilitation and other services and opportunities -- health, education and income, and to become active contributors to the community and society at large -- as do all other members of society.

2) To activate communities to promote and protect the human rights of PWD through changes within the community, for example, by removing barriers to participation.

3. Who are the targets?

People with disabilities Families of people with disabilities Communities Disabled People's Organizations Local, regional and national governments International organizations

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2012 autumn -- 429 U0210 Topics in Community-based Practice of Occupational Therapy

Nongovernmental organizations (NGO) Medical and other professionals Business and industry (private sector)

4. What kind of activities are included?

A wide range of activities is included beyond medical care and rehabilitation

Promoting positive attitudes towards people with disabilities Preventing the causes of disabilities Providing rehabilitation services Facilitating education and training opportunities Supporting local initiatives Monitoring and evaluating programmes Supporting micro and macro income-generation opportunities

5. What WHO is doing ?

With regard to CBR, WHO is supporting Member States in the following areas:

Developing guidelines for CBR Conducting regional and country workshops to promote CBR and the

guidelines Supporting Member States to initiate CBR and/or strengthening existing CBR

programmes

6. What are the essential elements of CBR?1) National level support through policies, co-ordination and resource allocation2) Recognition of the need for CBR programmes to be based on a human rights

approach.3) The willingness of the community to respond to the needs of their members with

disabilities.4) The presence of motivated community workers.

National level:1) Policies, legislation, and support to guide the priorities and planning of a CBR

programme. i.e. the UN Convention on the Rights of the Child, the UN standard Rules on the Equalization of Opportunities for Persons with Disabilities

2) The mechanism of co-ordinating committee (one or across ministry, health, social

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2012 autumn -- 429 U0210 Topics in Community-based Practice of Occupational Therapy

affairs, education or labour)3) Collaboration among all of the sectors (intermediate/distract level where referral

services are provided, Non Governmental Organizations, NGO) 4) Allocation of resources

Intermediate level—key point for coordination of support to communitiesCBR managers (i.e. ministry for social affairs), their duties include:

Implementing and monitoring of the programme, supporting and supervising the training of workers, linking various community committees, and liaising between the communities and other resources.

Community levelRepresentatives of community involving in the planning, implementation and

evaluation of CBR programmes.Recognition of the need for CBR, raising the awarenessCommunity involvement: respond the need

* sharing information is a key component of CBR

7. Who will be community workers?Local government, Volunteers, PWD, and their family members, NGO,

Media….Roles:1) Acts as advocate by making contacts with schools, training centres, work places

and other organizations to promote accessibility and inclusion.2) Provide information about the services available

As liaison between the families of PWD and such services

* CBR is now recognized by many governments as an effective strategy for meeting the needs of people with disabilities especially who live in rural areas.The expansion of programmes requires training for the people who will involved in the management and delivery of services.

8. What training programmes are needed for CBR?1) Management training: identify need, co-ordinating with the community and

sectors, recording2) Training for PWDs: to function as liaisons between community and other levels,

skills in advocacy, co-ordination, planning and evaluation, and fund raising.3) Training for service delivery (community workers and the professionals)

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2012 autumn -- 429 U0210 Topics in Community-based Practice of Occupational Therapy

討論：有參與過或聽聞過相關 CBR program？針對其目標、是否有法規依據、對象/參與者、主要活動內容、各層面的執行者。

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