COMMUNITY-BASED

REHABILITATION
INITIATIVE
TITLE: “Impact of community-based
rehabilitation on quality of life and self-
esteem of persons with physical
disabilities and their family members”
BACKGROUND
COUNTRY

African country specifically Nigeria.

TARGET POPULATION

1. Simple random selection of four geopolitical zones in Nigeria

namely North-Central, South-East, South-West and South-South.
2. PWDs and two family members of each of them (male/female).
3. Family members of PWDs were aged 18 years and above who
were actively involved in the care of the PWDs (must spend at least
six hours a week for the past one year with the client).
4. The PWDs had been resident in the selected areas for at least
three years.
PRIMARY GOALS

Investigate the impact of CBR on Quality of Life(QOL) and

Self-Esteem(SE) of PWDs and Family Quality of Life(FQOL)
of their family members.

Comparing the Quality of Life and Self-Esteem of PWDs in

communities with and without a CBR programme.

Investigate possible correlations between the Quality of Life,

Self-Esteem of PWDs and FQOL of their family members.
INTERVENTION STRATEGIES
World Health Beach Morris
Organization Centre Family Rosenberg’s
Quality of Life Quality of Life Self-Esteem
Instrument-short (BCFQOL) Scale
Form Scale

 used to assess  measures levels of family  used to assess the SE of

the quality of life of the perceptions of the
participants importance of different
domains of FQOL,
 has four domains and their satisfaction with
(physical health, those domains
psychological health,
social relationships and  scale contains 25 items and five
environment health) subscales namely: family
interaction (six items), parenting
(six items), emotional well-being
(four items), physical/material well-
being (five items), and
disabilityrelated support (four items)
PWDs and to measure
feelings of self-worth or self-
acceptance, and is
generally considered the
standard against which other
measures of SE are compared
 comprises 10 items that are
usually scored using a
four-point response ranging from
strongly disagree to strongly agree
OUTCOMES AND IMPACT
Many PWDs (26.5% in CBR and 32.2% in non-CBR) in this
study did not have any formal education, suggesting the
likelihood of limited opportunities for this population.

There was improved

family interaction as a
result of participation of
PWDs in family life, CBR
which may have been
due to involvement in
CBR.

The finding that the number of PWDs who had no

formal education was more amongst those who were
not in CBR, suggests that the PWDs in CBR and their
family members may have been encouraged to seek
education as this is one of the basic goals of CBR.
OUTCOMES AND IMPACT
 The impact of CBR on the QOL of PWDs could result in promoting
positive attitudes of the society towards PWDs, providing effective
services, establishing a rehabilitation network in the community,
ensuring accessibility of information and providing emotional
support for the PWDs and their family members.

 CBR impacted positively on the QOL and SE of PWDs who were

under a CBR project in some Nigerian communities; and on the
QOL of family members of PWDs in those Nigerian communities
who were under a CBR project. The QOL of PWDs in the Nigerian
communities significantly correlated with their SE and with the
QOLp of their family members.
CHALLENGES
Much of the society persists with
negative attitudes towards PWDs
who tend to be stigmatized.

Burden of coping with the associated

CBR stigma and absence of support, especially in the area
of provision of mobility, social inclusion and
empowerment.

The impact of disability is not only felt by

the PWDs alone but also by all members
of their immediate family, relations and
even the community.

Note: Since there was no record of the PWDs and no addresses available,
the researchers and assistants went from house to house in the non-CBR
communities in order to find them.
LESSONS LEARNED
There are many benefits
Greater involvement of family
to having a positive view
members and local communities
of the self.
enhances their ability to see what
they are achieving, and encourages
them to participate in the
socio-cultural and work lives of
To have a disability their community.
or impairment
does not mean
CBR
that someone can't
live their life normally. Raising awareness and educating
others is a huge part of the work.

Progress takes time. I have learned that CBR

We may find ourselves getting is truly a partnership and time
frustrated because we can’t commitments of both
see results straight away, healthcare providers and
but these things take time. community members.
REFLECTIONS
Importance of CBR in the field
of physical therapy.
 CBR allows the field of physical
therapy to create a sense of
human community and provide a
therapeutic environment in which
human beings can grow and take
responsibility for their growth.
 To encourage stakeholders to
facilitate the empowerment of
PWDs and their families by
promoting their inclusion and
participation in development and
decision-making processes.
Potential benefits and limitations of
implementing CBR initiatives.
 Facilitate a community level the
collaborative relationship between
communities and health services
empowers communities and develops
leadership.
 At the individual level, CBR projects
support the hiring and training of
Community Based Workers,
enhancing the qualifications, income,
and employability of local residents.
 The difficulties in putting CBR into
practice ranged from poor access to
social, health, educational, and
employment opportunities to isolation,
neglect, abuse, and violence.
Perspective on the role of physical
therapists in CBR and their impact
on community health and well-
being.
 Physical therapists could improve
personal satisfaction for people with
disabilities.
 Physical therapists need a high level
of adaptability and a wide range of
skills to facilitate a good
rehabilitation.
 Physical therapists requires an
improvement in a training program
that is more customer-focused in the
community.
 Physical therapists can be
providers of direct care, and
advisers to governments and local
communities, on establishing CBR
programmes.
Personal insights or connections
you made while conducting the
research and analysis.
1. The holistic approach of CBR must
includes participation of family
members of PWDs and members
of the community.
2. I can say that CBR approach
significantly improved the Quality
of Life of the benefitting PWDs and
their family members.
3. In addition to the disability, the
psychological state of PWDs can
be obvious concerns for the rest of
the family.
PERSONAL INSIGHTS
 PWDs’ better self-esteem may enhance better
participation in the community, thereby eliminating
participation restrictions and promoting equalisation of
which is a major goal of CBR.

 Rehabilitation programmes for PWDs can be described as

successful when such individuals are able to participate
fully in family and community activities.
REFERENCES

https://www.keaipublishing.com/en/
journals/global-health-journal/
Thank you!