SECTION 1

 

The value of the service offered by the community rehabilitation worker: Lessons from a review

 

 

R Binken^I; F Miller^I; M.E Concha^II

^ISudents in Occupational Therapy at the time the research was conducted
^IIBSc (OT), PhD (Witwatersrand); Honorary Professorial Research Fellow, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand

Correspondence

 

 

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ABSTRACT

This study was undertaken to assess the value of the Community Rehabilitation Workers (CRWs) to the people living in the rural community. Although CBR is no longer delivered through the services of CRWs the results of this evaluation were thought to be valuable in providing some lessons that would help in the implementation of an outreach service delivered by profession specific assistants. Both qualitative and quantitative methods were incorporated in the research design and analysis, all of which contributed to a judgment of the value of the CRWS' service.
The CRWs played a role in formulating the qualitative questions that were asked at a workshop. Resulting from this a questionnaire was compiled which provided information on the components of Community Based Rehabilitation delivered by the CRWs as per the definition given by the World Health Organisation (WHO) as well as information about the value of the service. In addition the CRWs' time and client's statistic sheets for a specified nine month time period were collected and analysed. The researchers compared their findings to a previous evaluation of the CBR programme.
The data collected provided information on the coverage i.e. the number and types of clients seen, the efficiency of the service through an analysis of the time usage, the effectiveness through an analysis of the resources to which clients had been referred as well as the perceptions of the CRWs regarding the value of the work that they were doing. Relevance was ascertained by looking at the activities that were engaged in during the work as well as through the interviews.
It was concluded that the CRWs provide a valuable service to the rural community in terms of the number of clients and the range of diagnoses they treat, assisting their clients to gain access to various resources, and through their use of appropriate activities and techniques for treatment and in their interaction with the community. They also felt that they offered a valuable service to the people with a disability in the villages that they served.

Key words: Community Based Rehabilitation, evaluation, community rehabilitation workers, service value

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References

1. Department of Health, SA A comprehensive Primary Health Care Service Package for South Africa: Pretoria, Government Printers 2001.         [ Links ]

2. Department of Health, SA: Rehabilitation for all, National Rehabilitation Policy. Pretoria, Government Printer, 2000.         [ Links ]

3. Misbach, S. The implications of the rehabilitation services package in the Metropole Health District, Western Cape province of South Africa. Unpublished mini thesis submitted in partial fulfillment of the requirements for the masters Degree in Public health, University of the Western Cape, 2004.         [ Links ]

4. CBR: A Strategy for Rehabilitation, Equalisation of Opportunities, Poverty Reduction and Social Inclusion of People with Disabilities. Joint Position paper, WHO, ILO, UN Education, Scientific and Cultural Organisation. WHO, 2004.         [ Links ]

5. World Federation of Occupational Therapists. Position Paper on Community based Rehabilitation (CBR) 2003. http://www.wfot.org/documents.asp? Accessed May, 2009.         [ Links ]

6. World Confederation of Physical Therapists. Position paper on Community Based Rehabilitation. 2007. http://www.wcpt.org/node/29565 http://wcpt.org/node/29565. Accessed May 2009.         [ Links ]

7. Department of Health, The Primary Health Care Package for South Africa - A set of Norma and standards: Pretoria, Government Printers, 2001.         [ Links ]

8. Pupulin, E. CBR: Where Are We Now. Paper presented at the Limuru CBR Seminar, Kenya, 1992.         [ Links ]

9. Mendis, P. Community Based Rehabilitation: Goals, Strengths and Weaknesses. Paper presented at the seminar on Community-Based Rehabilitation. Limuru, Kenya. 1992.         [ Links ]

10. McLaren P, Philpott, S., Rule, S, Reviewing the current status and future direction of Community-Based Rehabilitation in South Africa. Report on a workshop held at the Valley Trust. June 2004.         [ Links ]

11. Helander, E. Prejudice and Dignity - An Introduction to Community-Based Rehabilitation. United Nations Development Programme, Switzerland, 1993.         [ Links ]

12. Miles, S. Strengthening Disability and Development Work. Discussion paper, 1999.         [ Links ]

13. Dolan, C., Concha, M.E. & Nyathi, E. Community Rehabilitation Workers: Do They Offer Hope to Disabled People in South Africa. International Journal of Rehabilitation Research, 1995; 18 (3), 187-200.         [ Links ]

14. Dolan, C., Concha, M.E. & Nyathi, E. Developing New Categories of Health Worker: A Case Study of Community Rehabilitation Workers. (Unpublished). 1994.         [ Links ]

15. Cornielje, Training Community Rehabilitation Facilitators at the Alexandra Health Centre: Initial Findings from a Recent Evaluation. Critical Health, 1992; 40, 12-16.         [ Links ]

16. Jaffer, R. Monitoring and evaluation of Community Based Rehabilitation- Need for a Participatory Approach. In Finkenflugel, H. (ED), The Handicapped Community: The relation between primary health care and Community Based Rehabilitation. VU University Press: Amsterdam. 1993.         [ Links ]

17. Krefting, L. Evaluation in CBR. Paper presented at the Seminar on Community-Based Rehabilitation. Limuru, Kenya, 1992.         [ Links ]

18. O'Toole, B. A community-based rehabilitation programme for preschool disabled children in Guyana. International Journal of Rehabilitation Research, 1988; 11 (4), 323-334.         [ Links ]

19. Feuerstein, M.. Partners in Evaluation. Evaluating Development and Community Programmes with Participants. The Macmillan Press Limite: London 1992.         [ Links ]

20. Lysack, C.L. & Krefting, L Qualitative Methods in Field Research: An Indonesian Experience in Community Based Practice. Occupational Therapy Journal of Research, 1994; 14(2), 93-110.         [ Links ]

21. WHO booklets Helander, E.,Mendis, P Nelson,G., Goerdt, A. Training in the Community for People with a disabilities. WHO, Geneva, 1989.         [ Links ]

22. Finkenflugel, H. & Wolffers, IA Pragmatic Approach to CBR? In Finkenflugel, H.(Ed.). The Handicapped Community. The relation between primary health care and community based rehabilitation. VU University Press: Amsterdam, 1993.         [ Links ]

23. Punwar, A.J.. Occupational Therapy: Principles and Practice (Second edition) Williams and Wilkins: Baltimore, 1994.         [ Links ]

24. Meyer, C., Moagi, S. Determining priority needs of mothers with disabled children in Winterveld. South African Journal of occupational Therapy, 2000; 30 (2): 7-11.         [ Links ]

25. Lorenzo, T. Collective action for social change: disabled women in the Western Cape. Agenda, 2001; 47: 89-94.         [ Links ]

26. WHO Report: Making the most of existing health workers. WHO Geneva, Jan 2006.         [ Links ]

27. Schneider M. Claasens, M. Kimmie Z, Morgan, R, Naiker, S, Roberts,A. McLaren P We also count! The extent of moderate and severe reported and the nature of the disability experience in SA. Community Agency for Social Change, 1999.         [ Links ]

28. Coleridge, P CBR as Part of Poverty Reduction in CBR as part of Community Development. Edit S Hartley, University College London, Centre for International Child Health, London, 2006.         [ Links ]

 

 

Correspondence:
M. E. Concha
Honorary Professorial Research Fellow
School of Public Health
Faculty of Health Sciences
7 York Rd
Parktown 2193
Johannesburg
etel@icon.co.za

 

 

* Winner of the Vona du Toit Prize for the best 4th year Occupational Therapy Research Project in SA. 1996.