Community-based rehabilitation: The concept and its implementation

Medical rehabilitation has developed as an institution-based discipline, expensive, reaching only a small section of persons who need it and focusing on physical aspects of disability. This was particularly true in developing countries and rural areas. An approach was needed that addresses also social integration and quality of life and enables increased coverage at affordable cost. Community-bascd rehabilitation (CBR), conceived by WHO, envisaged delivering rehabilitation on community level through Primary Health Care. In almost all developing countries CBR is used to identify people with limitation in activity, cares for them and assists in their social integration. In rural areas of developed countries a variation of the model consists of rehabilitation provided by health workers and provision of appropriate technology; in urban areas professionals in the community increasingly provide rehabilitation services. The community model is a viable framework for rehabilitation both in developed and developing countries, and has much strength in post-armed conflict situations.