The evidence base for community-based rehabilitation: a literature review

Abstract

Literature on community-based rehabilitation (CBR) published between 1978 and 2002 is reviewed to assess the evidence base for CBR. There were 128 articles found that met the criteria set by the authors. The articles have been classified according to the methodology used and the key aspects studied. The review showed an ever-increasing number of publications on CBR. Theory papers and descriptive studies are the most common types of papers in CBR literature. Intervention studies and case reports are relatively rare. No systematic review has yet been carried out although reviews on specific aspects of CBR have become available. The key aspects of 'implementation' and 'stakeholders' are relatively well presented but the numbers of articles on 'participation' and 'use of local resources' are noticeably low. This study reveals that there is no real focus of research in CBR and therefore the evidence base for CBR is fragmented and incoherent on almost all aspects of CBR. It is recommended that comprehensive review studies should be carried out on key aspects of CBR projects. This should be supported by systematic research in CBR projects in order to establish evidence-based practices.

Fostering evidence-based practice in community-based rehabilitation: Strategies for implementation

“…In a review of 128 published CBR research articles, Finkenflugel, Wolffers and Huijsman 22 found that most CBR research was theoretical or descriptive in nature, with few rigorous evaluative studies and systematic reviews. Their primary recommendation was that more research into the effectiveness of CBR should be conducted as a matter of urgency.…”

Adaptation of the global frameworks for community based rehabilitation in southern Africa: a proof of concept

“…Because CBR addresses the issues of access, it is largely implemented in remote areas where rehabilitation personnel and infrastructure are otherwise absent. Its development and practice as a needs-based approach has evolved from a biomedical approach to a biopsychosocial approach [3][4][5] . In order to achieve its goals, CBR calls for the full and coordinated involvement of all levels of society: community, intermediate and national 3,6,7 .…”

“…In southern Africa, CBR was introduced to Angola, Botswana, Lesotho, Malawi, Mozambique, Namibia, South Africa, Swaziland, Zambia and Zimbabwe 4,[13][14][15][16] . Most often CBR programs are implemented at subdistrict levels, in rural and remote locations where rehabilitation personnel and infrastructure are non-existent.…”

Developing Local Resources in Community-Based Rehabilitation Programme in Sri Lanka: Follow-up Study in Anuradhapura

“…Higashida (2014b) classifies local resources in CBR into four types: human resources, structural resources, institutional resources and financial resources. As Finkenflügel et al (2005) and Mitchell (1999) underline, local resources including local technologies, cost effectiveness and referring system is important to enable the sustainability of CBR programmes. Although a great deal of research has been conducted on measures and indicators responding to demands for assessment and evaluation of CBR (e.g.…”

“…Although a great deal of research has been conducted on measures and indicators responding to demands for assessment and evaluation of CBR (e.g. Finkenflügel et al, 2005;Grandisson et al, 2014;Wirz & Thomas, 2002), the number of studies focusing on the use of local resources in CBR (e.g. Darain et al, 2013;Mannan et al, 2012) is noticeably low (Finkenflügel et al, 2005).…”