DISABILITY AND FAMILY:

COMMUNITY-BASED
REHABILITATION
Karen Garcia
Kevin Garzon
Laura Pumarejo
Jessica Cifuentes
Daniela Caro Trujillo
Laura Casallas Moreno
 Table of content
1. Background
2. Reference framework
3. Objectives
4.Conceptual foundations
5 Guiding principles of the CBR
6 fundamental premises
7. Methodological Reference
8. Footprint of RBC Colombia in the world
 what is cbr ?
It is a strategy for socioeconomic development and social inclusion that
allows satisfying basic needs, creating opportunities, developing
capacities, supporting and working with Organizations of People with
Disabilities and Support Groups, involving intersectoral participation,
promoting leadership and government participation. local and take
advantage of the legislative, legal and social systems of the country.
1. Background
 Background on the implementation
of the CBR strategy

2010, rapprochements In 2012, 2013 and 2014

were established between the validation,
the Group of Disability of socialization and
Social Promotion of the construction of indicators
Ministry of Social was carried out
Protection in 2012 the CBR
In 2011, the process of Guidelines of the World
formulating guidelines Health Organization -
was carried out WHO were published
 International and Continental CBR
Overview

CBR was proposed by the WHO in

the early 1980s and was structured
on the basis of community work
experiences in Africa.
In Latin America, it was developed
with the support of PAHO.
International and Continental CBR
Overview

It was implemented in Colombia

between the 1980s and 1990s and
included training in the health area.
In Bogota in 1994 it began with
differential and staggered
developments of its components.
 International and Continental CBR
Overview
After the declaration of Alma Ata
in 1978, the WHO adopted
Community Based Rehabilitation
(CBR).
CBR shares the idea of primary
health care and involves the
operational modification of
traditional services.
It also expresses a shift in
fundamental values and
principles.
CBR implementation in Colombia

In Bogota, a CBR experience was

carried out in the localities of
Tunjuelito and Rafael Uribe.
At the end of the 80's In Valle del
Cauca, CBR experiences began with
proposals in physiotherapy
programs.
 CBR implementation in Colombia

1990 development of the strategy by some organizations.

1998, Waal Foundation conducted a training of trainers course with the rehabilitation
committee of Antioquia.
2003 First national CBR meeting in Cartagena followed by Medellin, Cali, Bogota, Pereira,
Yopal.
2000-2003 Development of strategies in twelve neighborhoods of Cartagena.
2004 Development of a training project for institutional and community agents to
implement CBR.
Bogota pioneer city in CBR implementation
2005-2007 Systematization of experience through a research exercise.
2008-2010 Expansion strategy
 CBR implementation in Colombia
Processes related to:
The gradual transformation of the concept
of disability.
The promulgation of the Convention on the
Rights of Persons with Disabilities.
The formulation and implementation of
policies with a differential and/or
population-based approach in the national
territory.
Social organizations and movements have
gained strength in political advocacy and in
the will of governments.
2. Referential framework
 CBR COMPONENTS

HEALTH EDUCATION
Primary Health Care Persons with disabilities have
promotion access to health and lifelong
prevention learning to achieve their
diagnosis potential, sense of participation,
treatment dignity and self-esteem.
rehabilitation
 CBR COMPONENTS

SOCIAL MOBILIZATION
SUBSISTANCE
It is promoted to conform Training processes and job
higher levels of opportunities
autonomy Livelihood and social
organization protection programs
participation of the Improved quality of life in
population with family environments
disabilities.

Social Protection
Framework
This focuses on the basic
requirements of the person
with disabilities; it seeks to
ensure that the person has and
is in minimally dignified
conditions of subsistence,
protection and affection.
CBR COMPONENTS
SOCIAL
Social Cohesion
Framework
Focuses on the inclusion of
people with disabilities in the
family and local society; the
emphasis is on meeting the
needs of understanding,
participation, leisure and
creation.
Development
Equalization Framework
Emphasizes the equalization of
opportunities and the
recognition of differences and
human diversity as a
constituent element of the
human being
THE CBR FROM A RIGHTS-BASED
APPROACH

UN Convention on
Timely and inclusive
the Rights of
access to goods and
Persons with
services, both for
Disabilities
persons with
disabilities and the
general community.
CBR AND INCLUSIVE
LOCAL DEVELOPMENT
Inclusive development promotes
a recognition of diversity in all
structures and areas of public
policy: education, health, welfare,
economy, among others areas of
public policy: education, health,
welfare, economy, among others.
This inclusion also refers - as
mentioned above - to universal
design, human diversity and
accessibility.
 THE DIFFERENTIAL APPROACH AND CBR

Gender & Sexual Diversity

Belonging ethnicity
Life Cycle Stages and
Generational Perspective
Particularity of the
limitations
Armed conflict
Emergencies and unrest
 THE PSYCHOSOCIAL APPROACH
AND CBR

Overcoming
adverse
situations
Understanding
the context
3. Objectives
General Objective

To guide the different actors and sectors at the national and territorial levels on the
implementation of the Community Based Rehabilitation - CBR strategy in Colombia.

Specific objectives
Unify the criteria and related concepts that identify the CBR strategy.
To provide methodological support for the implementation of the CBR strategy based
on the CBR Guidelines issued by WHO - PAHO. the CBR Guidelines issued by WHO -
PAHO.
Promote dialogue among the different sectors and actors for its strengthening and
sustainability. sustainability
4. Conceptual foundations
 participation

Disability
A person with a disability is one
who presents a deficiency in body
function and / or structure, which
may present limitations in their
activities, as well as restrictions on
full and effective social
participation, which depends on
the barriers or facilitators present
in the environment.

Inclusion
is a process in which the
rehabilitation
physical, mental and social
capacities of people with
disabilities to achieve the highest
level of possible independence
for their participation and social
inclusion.
comunity
It is considered as a group of people
with needs, common interests,
practices and perceptions, which
have their own knowledge and
share values, beliefs, meanings and
norms of coexistence and that can be
permeated by external factors; in it
the individual-community-society
dynamic is evidenced.
 Community based
The concept based on community
is linked to social justice, social
leadership and the empowerment
of different social actors in the
search for alternatives aimed at
the social inclusion of people with
disabilities.
community-based It is a tool to act from the perspective
of inclusive development allowing to
rehabilitation recognize the environment, design
responses, plan actions, mobilize
content, articulate efforts of the
government, social organizations and
provide solution systems to common
situations in characterized and fully
identified groups.

manifestation of a need

community response Support availability

5 Guiding principles of the cbr
 The principles that guide the planning and strategy
development process are in harmony with those of the
United Nations Convention.
United Nations on the Rights of Persons with Disabilities

Respect for dignity, individual autonomy,

freedom of make your own decisions,
and people's independence.
Non-discrimination
Full and effective participation and
inclusion in society
Respect for difference and acceptance of
people with disabilities as part of
diversity and the human condition
Equal opportunities
To accessibility
Equality between men and women
6. FUNDAMENTAL PREMISES
 Community self-management
Is a process by which the capacity is developed individual or group to
identify interests or basic needs, which enhances the use of the
best values of the individual and of the groups, placing them in better
position to face and solve your common problems.

It includes the following factors:

 Political Incidence
In the hands of people with disabilities, their
families, caregivers and communities, becomes
a possibility to expand their ability to influence
mainly those who have the responsibility of
taking the decisions on matters relating to your
guarantee of rights
Instances of National Disability System
Empowerment
Process by which people gain knowledge,
strengthen their capacities, trust, vision and
leadership as a social group to promote positive
changes in the living situations freedom to choose
and act on circumstances socioeconomic and
policies that affect it.
 Intersectorality
Articulation of knowledge and experiences of different
sectors in planning, carrying out and evaluating actions,
with the aim of achieving integrated results in complex
situations in social development.

fundamental premises for intersectoral work:

1. Integration between sectors enables the search for

comprehensive solutions.
2. Integration between sectors allows the differences
between them to be used productively to solve social
problems.
 Systematicity
Set of rules and protocols that allow ensuring maximum
horizontality in relationships between actors,
memorizing processes and establishing lessons learned
it must be present from decision making to final
evaluation.

The aforementioned premises allow us to visualize

community work through which implements
Community Based Rehabilitation:
Self-management, empowerment
and advocacy These three premises
must be supported by other basic
ones such as the intersectoral work
that must characterize CBR and
systematicity as an element
essential to achieve knowledge
management in the
implementation of experiences of
this type.
7. METHODOLOGICAL REFERENCE
 The Guides provide CBR
This section takes up as a administrators and executors with
fundamental input the practical suggestions on how to
CBR guidelines issued by develop or strengthen CBR
WHO - PAHO. programs, ensuring that people with
disabilities and members their
family have access to plans,
programs, projects and services in
the health, education, subsistence
and social sectors.
 COMPONENTS AND ELEMENTS:
COLOMBIA MATRIX

Health subsistence
promotion Education skill development
prevention early childhood I work on my own accord
medical attention primary remunerated job
rehabilitation Not formal financial services
personal assistive devices social protection
lifelong learning
secondary and higher
 social
personal assistance
relationships, marriage
, family and community
culture and arts
recreation and sports
Justice
empowerment
communication
social mobilization
political participation
support networks
organizations of people
with disabilities

The guides present definitions, goals, role of CBR, expected results

and activities that have to be carried out to fulfill the purposes
outlined.
 SPECIAL GROUP ATTENTION

CBR AND MENTAL HEALTH

CBR AND HIV AIDS
CBR AND LEPRA
CRB IN CRISIS
HUMANITARIAN
PLANNING AND IMPLEMENTATION OF CBR WITHIN THE FRAMEWORK OF
THE NATIONAL DISABILITY SYSTEM

CBR is an engine that streamlines

the operation of the National
Disability System, while at the
municipal and / or local level the
public policies on disability in
Colombia are deliberated, built and
monitored the participation of people with disabilities, their
families and the community are essential in the
planning, implementation, follow-up and
monitoring process of the CBR strategy
 ACTORS, SECTORS AND THEIR ROLES
People with disabilities and their families, public and private
institutions from different sectors, and organizations of and for
people with disabilities are identified as actors in CBR processes.

The actors that should be part of the planning and implementation of CBR
programs / projects are:
The person with a disability, their family and caregivers
The local community
Civil society
Organizations of and for people with disabilities
Territorial administrations
Community agents or leaders
 DEVELOPMENT OF THE NETWORK OF rbc
NETWORKS IN COLOMBIA
A gestation began around 2003 in the framework of the First Meeting of RBC
experiences, held in the city of Cartagena
was consolidated in the fourth version of this meeting (Bogotá, 2007)

OBJETIVES
Place the issue of disability on the public agenda.
Achieve the articulation of the actors and interests.
Develop knowledge in RBC.
Promote the quality of the processes developed in RBC
 The nodes have as main purposes:
Articulate different sectors (public and private), actors and
levels of RBC.
Follow up on the organizations that carry out CBR in the
territories.
Systematize the experiences of the region.
Summon actors.
Make visible good practices or successful experiences from
RBC
Position the strategy on local agendas.
Articulate and unify criteria, knowledge and experiences
based on
what the Nodes offer from their diversity.
 GENERAL METHODOLOGICAL
GUIDELINES
Structure with a strategic sense all the logic of the process to be promoted:
participants
personal and group characteristics
needs
interests,
context in which they live
knowledge on the subject
objectives to be achieved
stages to be developed to achieve them
thematic sequence to be followed,
techniques and procedures to be used at different times.
 guide for all those stakeholders interested
in using this strategy.
1. Identification and awareness of actors
2. Situational diagnosis
3. Updating of the Registry for the Location and Characterization of People with
Disability
4. Creation and strengthening of CBR commissions or committees
5. Formulation of action plans
6. Resource management and consultation
7. Training of facilitators
8. Articulation with support networks
9. Implementation of actions in favor of the social inclusion of people with
disability, their families and the community
10. Control, monitoring and evaluation
Rompecocos de la RBC ”which seeks to guide the development of the proposed actions in
the strategy planning route:
8. FOOTPRINT OF COLOMBIAN GUIDELINES
ON WORLD cbr
The learnings left within this construction process have given the possibility not only of
generating a document of National Guidelines for Community-Based Rehabilitation for
Colombia, but also the possibility of reflecting on:

The participation of a diversity of actors and sectors in the construction of the guidelines that
collect the feelings of almost all regions through Nodes
In addition to being a strategy, RBC becomes Public Policy
The participation of the National Government in the implementation of the CBR strategy
The participation of people with disabilities and organizations of and for people with
disabilities in the construction and implementation of RBC
The Colombian experience in RBC compared to other countries.
 Bibliography
Ministerio de salud, (2014), Lineamientos Nacionales de Rehabilitación Basada
en Comunidad para Colombia, recuperado de
https://discapacidadcolombia.com/phocadownloadpap/GOBIERNO/lineamiento
s-nacionales-rbc.pdf
Lemmi, V. (2016), Community-based rehabilitation for people with disabilities
Ministerio de salud y protección social, (s.f), Rehabilitación basada en
comunidad.