Community based rehabilitation for people with disabilities in low- and middle-income countries: a systematic review

Abstract

This Campbell systematic review looks at the evidence from different types of community‐ based rehabilitation interventions in low‐ and middle‐income countries, which target different types of physical and mental disabilities. This review summarises findings from 15 studies, six which focus on physical disabilities and nine on mental disabilities. Moderate to high quality evidence shows that community‐ based rehabilitation has a positive impact on people with disabilities. Of six studies focusing on CBR for people with physical disabilities, three showed a beneficial effect of the intervention for stroke on a range of outcomes while one found a smaller effect; one study found a beneficial impact of CBR for arthritis; and one showed a positive impact of CBR for people with chronic obstructive pulmonary disease. The nine studies assessing the impact of CBR for people with mental disabilities showed a beneficial effect on schizophrenia (5 studies), dementia (3 studies) and intellectual disability (1 study). None of the studies that met the review's inclusion criteria included economic evaluations of community‐based rehabilitation. Synopsis/Plain Language Summary COMMUNITY‐BASED REHABILITATION FOR PEOPLE WITH DISABILITIES IN LOW‐ AND MIDDLE‐INCOME COUNTRIES: A SYSTEMATIC REVIEW.Review questionWe reviewed the evidence about the impact of community‐based rehabilitation on the lives of people with disabilities and their carers in low‐ and middle‐income countries.BackgroundPeople with disabilities include those who have long‐term physical, mental, intellectual or sensory impairments, which in interaction with various barriers may hinder their full and effective participation in society on an equal basis with others. There are estimated to be over one billion people with disabilities globally and 80% of them live in low‐ and middle‐income countries. They are often excluded from education, health, and employment and other aspects of society leading to an increased risk of poverty. Community‐based rehabilitation interventions are the strategy endorsed by the World Health Organization and other international organisations (e.g. ILO, IDDC) for addressing the needs of this group of people in low‐ and middle‐income countries. These interventions aim to enhance the quality of life of people with disabilities and their carers, by trying to meet their basic needs and ensuring inclusion and participation using predominantly local resources. These interventions are composed of up to five components: health, education, livelihood, social and empowerment. Currently only few people who need them benefit from these interventions, and so it is important to assess the available evidence to identify how to best implement these programmes.Study characteristicsThe evidence in this review is current to July 2012. This review identified 15 studies that assessed the impact of community‐based rehabilitation on the lives of people with disabilities and their carers in low‐ and middle‐income countries. The studies included in the review used diffe...

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