Promoting the rights of Children with disabilities innocenti digest no

Community-based rehabilitation
A specific form of local support is community-based 
rehabilitation (CBR) programmes that are designed and 
run by local communities. CBR, which was first devel-
oped in the late 1970s and early 1980s by the World 
Health Organization (WHO), is a “strategy which, 
within general community development, promotes 
rehabilitation, equalization of opportunities, poverty 
reduction and social inclusion for all children and adults 
with disabilities at a local level.” The major objective 
of CBR is to ensure that persons with disabilities and 
their families enjoy access to regular services and op-
portunities. In this way, they become active members 
of their communities and, equally, communities feel a 
sense of ownership with regard to these projects.
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Community-based rehabilitation is implemented 
through the combined efforts of persons with 
disabilities themselves and their families in the 
neighbourhood, along with the appropriate health, 
education, vocational and social services. The 
potential of CBR is fully realized when there is a 
strong culture of sharing information about good 
practice, and in providing evidence about coverage, 
quality of service, sustainability, comparability and 
cost effectiveness – a key characteristic of CBR 
projects when they are well managed.
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Community-based rehabilitation can benefit everyone 
in the community. For example, when the community 
makes changes to facilitate access for persons with dis-
abilities, it makes life easier for others who were not rec-
ognized as having disabilities. If the community clears 
walkways and makes them smooth for wheelchairs to 
move easily, or for people with visual impairments to 
walk, then these walkways are also made easier for 
older persons or those pushing carriages or carts. Ad-
ditionally, CBR can serve as a stimulus for community 
leaders and social groups to work together.
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Box 6.4 Using local resources to produce 
low-cost aids in Mexico and the Philippines
Projimo (Program of Rehabilitation Organized 
by Disabled Youth of Western Mexico) has 
promoted community-based health and 
rehabilitation initiatives.
i
A programme run 
from the outset by and for persons with 
disabilities, Projimo broke new ground in grass-
roots health and empowerment. 
Among Projimo’s many initiatives is its Skills 
Training and Work Programme that provides 
constructive work opportunities. This includes 
the Children’s Wheelchair Project in the 
Sierra Madre mountains that produces low-
cost wheelchairs customized to fit individual 
needs. Using wood, metal, bicycle tyres and 
basic designs, the project produces over 100 
individually designed wheelchairs each year. 
The demand for these wheelchairs is extremely 
high, and the master wheelchair builder, who 
has an impairment himself, receives requests 
to train community-based craftworkers from all 
across Mexico. The Netherlands-based Stichting 
Liliane Fonds helps to cover the cost of the 
wheelchairs for children from poor families.
ii
Most of the wheelchairs found in the Philippines 
are donated from other countries. However, 
harsh road conditions in rural areas necessitate 
customized wheelchair production. In 1996, 
the National Federation of Disabled Persons 
(KAMPI), with support from the Department 
of Social Welfare and Development and a 
fundraising organization associated with a 
Japanese newspaper, set up a training project 
for persons with disabilities who were interested 
in making wheelchairs in their own communities. 
Within months, KAMPI affiliate organizations 
were producing low-cost wheelchairs using 
materials that can be purchased from any local 
bicycle store: frames made of steel tubes and 
wheels using bicycle tyres. Repairs are normally 
be made by local welders or mechanics. KAMPI 
wheelchairs were found to be both sturdier and 
less costly than commercial wheelchairs.
Sources:
i
 United Nations Economic and Social Commission for 
Asia and the Pacific, ’Production and Distribution of 
Assistive Devices for People with Disabilities: Part 1’, 
United Nations, New York, 1997,
english/intl/z15/z15001p1/z1500101.htm>, accessed 17 
August 2007.
ii
 Project Projimo,
projimo/projimo.htm> and
principal.htm>, accessed 17 August 2007.

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Promoting the Rights of Children with Disabilities
Innocenti Digest No. 13
A global resource for the promotion of CBR is 
provided by WHO’s Programme on Disability and 
Rehabilitation, which is discussed in box 6.3.
Community-based rehabilitation is a general strategy, 
within which specific initiatives will respond to local 
situations. In Guyana, for example, a CBR project 
was started in the coastal areas of the country by 
parents of children with disabilities. Subsequently, 
the decision was taken to extend the programme 
to indigenous Amerindian communities in the 
interior. As a first step towards establishing a CBR 
programme in the region of Rupunini, a meeting 
was organized to which community leaders from the 
surrounding villages were invited. When it emerged 
that some of the villages had no schooling facilities 
whatsoever, it was decided that the CBR programme 
would support the setting up of village schools as 
well as training activities for teachers, village health 
workers and community volunteers. 
Within this structure, the communities themselves 
promoted the issue of education for children with 
disabilities. This example illustrates how taking a 
disability perspective from the initial stages of a 
project and working within a community context 
helps to promote education for all.
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Other interesting CBR initiatives discussed in box 
6.4 illustrate how low-cost local solutions offer the 
advantage of being both sustainable and sensitive to 
specific situations.