Training Needs of Community-based Rehabilitation Workers for the Effective Implementation of CBR Programmes

Abstract

Purpose: This review investigates the training needs of Community-Based Rehabilitation (CBR) workers that would enable them to effectively facilitate CBR programmes. Emphasis was placed on identifying: (a) the skills that CBR workers require (b) the training currently available for them, and (c) the gaps in current training.Method: A scoping review was conducted using on-line database searches (Medline, Embase, Cinahl, PsycInfo, Global Health) for English articles from 2006 onwards. A combination of keywords related to CBR, personnel, and training were applied. Hand searches of reference lists and the DCID journal were also conducted. Grey literature related to training, from the World Health Organisation (WHO), CBR Regional Networks and organisations affiliated with CBR were included as secondary data. Thirty-three articles and thirty-five sources from the grey literature were included. Data was organised under the three objectives outlined above – i.e., required skills, available training and training gaps.Results: CBR workers represent a diverse group requiring a broad range of skills. A new cadre of mid-level workers is also necessary to effectively implement the CBR guidelines. There is currently no standardised training for CBR workers and training varies widely, depending on context. CBR workers require further training in various clinical, social, management, communication, and cultural competence skills across the spectrum of the CBR Matrix, and specifically in empowering persons with disabilities and facilitating community development. They also need to develop critical reasoning, creativity, and compassion.Conclusion: A standardised approach to training CBR workers would be beneficial to ensure basic standards and quality services, to allow meaningful comparison and evaluation across contexts, to recognise the role of mid-level CBR workers, and to strengthen the workforce. Further research is required to determine minimal competencies, define the roles of various CBR workers, and evaluate the effectiveness of training.

Sustainable support solutions for Community-Based Rehabilitation Workers in refugee camps: Piloting telehealth acceptability and implementation

“…This study incidentally identi ed some speci c diagnoses in which CBR workers feel they require more support, and whether assistance was most needed before, during, or after telehealth sessions, which carries its own implications for the training and support needs of CBR workers [4]. Similar to other studies completed in LMICs, this study also identi ed some cultural barriers and beliefs that might limit progression of technology use in LMIC [17].…”

“…Studies delineate three levels of CBR workers: grass-root, mid-level and professional. Typically, grass-root workers are volunteers that may have several weeks of non-accredited training and mid-level workers have some form of accredited training to provide services without the supervision of a professional, supervise a grass-roots worker, and manage CBR programs [4]. Professionals have a formally accredited, certi ed degree and can be responsible for training and supporting mid-level workers through referral systems in which clients can attain more specialized services [4].…”

“…Typically, grass-root workers are volunteers that may have several weeks of non-accredited training and mid-level workers have some form of accredited training to provide services without the supervision of a professional, supervise a grass-roots worker, and manage CBR programs [4]. Professionals have a formally accredited, certi ed degree and can be responsible for training and supporting mid-level workers through referral systems in which clients can attain more specialized services [4]. The literature suggests training midlevel workers in "professional" level capacities to address the de cit of trained rehabilitation professionals in LMIC yet acknowledges several ethical and procedural hindrances to implementing such comprehensive protocols [4].…”

“…Professionals have a formally accredited, certi ed degree and can be responsible for training and supporting mid-level workers through referral systems in which clients can attain more specialized services [4]. The literature suggests training midlevel workers in "professional" level capacities to address the de cit of trained rehabilitation professionals in LMIC yet acknowledges several ethical and procedural hindrances to implementing such comprehensive protocols [4]. Furthermore, studies recognize that initial training fails to address the ongoing support CBR workers require [4].…”

“…The literature suggests training midlevel workers in "professional" level capacities to address the de cit of trained rehabilitation professionals in LMIC yet acknowledges several ethical and procedural hindrances to implementing such comprehensive protocols [4]. Furthermore, studies recognize that initial training fails to address the ongoing support CBR workers require [4]. The lack of specialty training and continuous service delivery support for CBR workers in LMIC is a barrier to comprehensive and effective rehabilitation intervention in CBR programs [5,6].…”