CBR in Afghanistan

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