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

Iemmi, Valentina; Blanchet, Karl; Gibson, Lorna; Kumar, K Suresh; Rath, Suchitra; Hartley, Sally; Murthy, Gudlavalleti V S; Patel, Vikram; Weber, Joerg; Kuper, Hannah

doi:10.1080/19439342.2016.1157623

Cited by 39 publications

(36 citation statements)

References 24 publications

(34 reference statements)

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“…This is in line with prior research referring to the lack of access to health-care and special education services generally in the Arab countries and specifically in Egypt (Gobrial et al 2018;Hadidi and Khateeb 2015;Omar 2014;Gobrial 2012;Jenkins et al 2010). Also, this is consistent with the previous literature concerned limited resources, underdeveloped health systems and scarce knowledge of ASD those living in lowto middle-income countries (Blake et al 2017;Tilahun et al 2016;McKenzie and McConkey 2015;Iemmi et al 2016).…”

Section: Discussionsupporting

confidence: 92%

The Lived Experiences of Mothers of Children with the Autism Spectrum Disorders in Egypt

Gobrial

2018

Social Sciences

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The aim of this study was to gain insight into the experiences of mothers caring for children with autism spectrum disorders (ASD) in relation to the early life, resources and to address the consequences of raising a child with ASD in Egypt. Semi-structured interviews were conducted with 14 mothers of children with ASD in Egypt, the children were aged 5–14 years old (mean: 7.3 years). Data were thematically analysed. Results revealed that life with ASD was daunting for the Egyptian mothers. Findings suggested that provision of inadequate education, healthcare and stigma constitute the main issues for mothers. Furthermore, ASD impacted negatively on the social life, emotional wellbeing and sacrifices of mothers of children with ASD. The findings provided valuable insight into the life of mothers, revealing what life really is like for mothers caring for a child with ASD in one of the low-medium-income countries. Understanding the mothers’ experiences of caring for children with ASD is crucial in providing support and developing the services that are urgently needed in Egypt.

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Section: Discussionsupporting

confidence: 92%

The Lived Experiences of Mothers of Children with the Autism Spectrum Disorders in Egypt

Gobrial

2018

Social Sciences

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“…For persons living with psychosis , five systematic reviews were found relating to community-based interventions [ 28 , 36 , 38 , 45 , 49 ], from which 13 relevant evaluations were identified [ 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 ]. All eligible evaluations were set in middle-income countries, including six in China [ 76 , 81 , 82 , 85 , 86 , 87 ], three in India [ 77 , 78 , 80 ], two in Iran [ 79 , 83 ] and one each in South Africa [ 75 ] and Turkey [ 84 ].…”

Section: Resultsmentioning

confidence: 99%

The Role of Communities in Mental Health Care in Low- and Middle-Income Countries: A Meta-Review of Components and Competencies

Kohrt

Asher

Bhardwaj

et al. 2018

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Community-based mental health services are emphasized in the World Health Organization’s Mental Health Action Plan, the World Bank’s Disease Control Priorities, and the Action Plan of the World Psychiatric Association. There is increasing evidence for effectiveness of mental health interventions delivered by non-specialists in community platforms in low- and middle-income countries (LMIC). However, the role of community components has yet to be summarized. Our objective was to map community interventions in LMIC, identify competencies for community-based providers, and highlight research gaps. Using a review-of-reviews strategy, we identified 23 reviews for the narrative synthesis. Motivations to employ community components included greater accessibility and acceptability compared to healthcare facilities, greater clinical effectiveness through ongoing contact and use of trusted local providers, family involvement, and economic benefits. Locations included homes, schools, and refugee camps, as well as technology-aided delivery. Activities included awareness raising, psychoeducation, skills training, rehabilitation, and psychological treatments. There was substantial variation in the degree to which community components were integrated with primary care services. Addressing gaps in current practice will require assuring collaboration with service users, utilizing implementation science methods, creating tools to facilitate community services and evaluate competencies of providers, and developing standardized reporting for community-based programs.

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“…Community-based rehabilitation (CBR), which combines support for individuals and families with community mobilisation, may meet this need. There is a well-established global network of CBR programmes, which have traditionally supported people with physical disabilities in the domains of health, social life, livelihoods, education and empowerment [ 9 , 10 ]. CBR is increasingly known as community-based inclusive development, reflecting a growing emphasis on the goal to be achieved rather than the process; however, the term CBR will be used in this paper.…”

Section: Introductionmentioning

confidence: 99%

“…CBR is increasingly known as community-based inclusive development, reflecting a growing emphasis on the goal to be achieved rather than the process; however, the term CBR will be used in this paper. CBR programmes vary and delivery personnel may include paid non-specialists, volunteers, physiotherapists, community nurses, and teachers [ 9 ]. For example, the Rehabilitation and Prevention Initiative against Disability (RAPID) programme in Adama, Ethiopia, enabled local field workers, teachers and parent groups to support the physical rehabilitation and social inclusion of children with disabilities ( https://www.cbm.org/Rehabilitation-and-education-in-Ethiopia-488115.php ).…”

Section: Introductionmentioning

confidence: 99%

Community-based rehabilitation intervention for people with schizophrenia in Ethiopia (RISE): a 12 month mixed methods pilot study

et al. 2018

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BackgroundCommunity-based rehabilitation (CBR), or community-based inclusive development, is an approach to address the complex health, social and economic needs of people with schizophrenia in low and middle-income countries. Formative work was undertaken previously to design a culturally appropriate CBR intervention for people with schizophrenia in Ethiopia. The current study explored the acceptability and feasibility of CBR in practice, as well as how CBR may improve functioning among people with schizophrenia.MethodsThis mixed methods pilot study took place in rural Ethiopia between December 2014 and December 2015. Ten people with schizophrenia who were unresponsive to treatment with medication alone, and their caregivers, participated in CBR. CBR was led by lay workers with five weeks training and involved home visits (education, family intervention and support returning to work) and community mobilisation. Theory of change was used to guide the pilot evaluation. Qualitative and quantitative data were collected at baseline, six months and 12 months. Forty in-depth interviews and two focus group discussions were conducted with 31 individuals comprising people with schizophrenia, caregivers, CBR workers, supervisors, health officers and community members.ResultsThe RISE CBR intervention may have a positive impact on functioning through the pathways of enhanced family support, improved access to health care, increased income and improved self-esteem. CBR was acceptable to CBR workers, community leaders and health officers. Some CBR workers found it challenging to accept the choices of people with schizophrenia. These concerns were felt to be resolvable with supplementary training for CBR workers. The intervention was feasible but further evaluation is needed on a larger scale.ConclusionIn low and middle-income countries, CBR may be an acceptable and feasible adjuvant approach to facility-based care for people with schizophrenia. However, contextual factors, including poverty and inaccessible anti-psychotic medication, remain substantial challenges. There were indications that CBR can impact on functioning but the RISE trial will determine effectiveness.Electronic supplementary materialThe online version of this article (10.1186/s12888-018-1818-4) contains supplementary material, which is available to authorized users.

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

Cited by 39 publications

References 24 publications

The Lived Experiences of Mothers of Children with the Autism Spectrum Disorders in Egypt

The Lived Experiences of Mothers of Children with the Autism Spectrum Disorders in Egypt

The Role of Communities in Mental Health Care in Low- and Middle-Income Countries: A Meta-Review of Components and Competencies

Community-based rehabilitation intervention for people with schizophrenia in Ethiopia (RISE): a 12 month mixed methods pilot study

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