Conceptualisation of community-based rehabilitation in Southern Africa: A systematic review.
Vyvienne R P M'kumbuzi, Hellen Myezwa
PMID 30135885WHAT IT FOUND
Southern African literature described community-based rehabilitation as centred on people with disabilities and families, with grassroots, mid-level and professional workers.
It did not test what these programmes do for patients.
Key findings
01The reviewed Southern African CBR articles described CBR concepts centred on power and politics in CBR programmes, access to rehabilitation, task shifting and CBR impact.
02Descriptions converged around empowerment, livelihood, health and education, and placed people with disabilities and their families at the centre of CBR.
03CBR delivery was described as a three-tier system of grassroots workers, mid-level rehabilitation workers and professionals, with government responsible for policy formulation, coordination and resource provision.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only nine peer-reviewed articles were reviewed, so the picture of CBR in Southern Africa is narrow. Seven of the reviewed articles were about CBR in South Africa, so the findings may not represent other SADC countries. Methodological rigour varied from 4 to 10 on CASP, and most articles did not consider the relationship between researcher and participants. No article had a randomised control study design to show the efficacy of CBR interventions. Social science electronic databases were not included because of cost, so relevant descriptions may have been missed. The reviewed articles referred to disability in general and did not define disability categories, gender or age groups.
The easy way to misread this
Do not read the described CBR model as evidence that it improves rehabilitation outcomes. The review reports how nine articles described CBR, and the authors state no randomised control study design showed efficacy.