Methodolgy

Core Programme Clusters

Disability, Injury Prevention & Rehabilitation

Community Based Rehabilitation, an Urban Experience Methodology		Foreword Community Based Rehabilitation Why CBR? How we did CBR? Activities Methodology Lessons from the field Evaluation Sustainability Acknowledgement Contact
	Various methods were used for the training of the local supervisors. Lectures, discussions, role plays, case studies, field visits, demonstrations, practical work, participation in reviews were all opportunities for training. The modules of the WHO manual were used one at a time with a mix of theory and practical work relating to each module. The volunteers were encouraged to present existing local Problems (or situations) and suggest relevant solutions to solve them with available resources.
Training also focused on communication, listening skills, and how to create rapport in the family and community. It was interesting to find that the volunteers were able to spell out the basic principles involved in communication and listening from their practical life experience, although they were unaware that they possessed such skills and were unsure of how to apply them formally. The field surveys were a sensitisation process for the whole team regarding problems faced by PWD in the real world. This stimulated the enthusiasm and motivation of the volunteers and trainers. Solutions to problems were planned along with the PWD, their families, project team and experts. Positive results gave rise to further motivation and failure to solve the problems led to repeating the process, looking for the causes of failure and finding new solutions.
	With time and experience, the volunteers developed confidence and often project staff drew inspiration, and learned many valuable lessons from them and the approaches that they used. (e.g. As a part of identifying people with difficulty in seeing, one of the Local Supervisors suggested that inability to pick out the stones from the grains of rice could be as effective a method, to detect decrease in vision as testing with formal charts.)
The problem solving methodology was found to be an excellent “educative” model. The Local Supervisor would identify the problem faced by the PWD with their help. Possible solutions were discussed with other project staff and resource persons, using the WHO manuals as resource material. The suggested interventions were implemented after discussions with the persons concerned and their family members. Problems encountered during intervention were solved locally, or brought back for discussion, during review meetings.
	Some problems were complex enough to warrant field visits by the project staff including the medical team. During these visits, the team and the persons with disability together analysed the situation and suggested interventions including referral to secondary and tertiary centres as appropriate. Recognising that a certain number of PWD do need intervention at secondary/tertiary setup, the team planned to use the already existing facilities and infrastructure to make this care available as and when needed. This care would also be provided to other people in the community who had medical needs, through the Volunteers, thus strengthening their image in the community. Sometimes the problem needed the help of the Government systems or of the local leaders. (e.g. Linking persons with DOTS scheme for Tuberculosis; Facilitating PWD to get ID card from the District Disability Rehabilitation Office)