The Ghana Community-Based Rehabilitation Program for People With Disabilities: What Happened at the End of Donor Support?

Abstract

In this case study the authors examined the functioning of the community-based rehabilitation (CBR) program for people with disabilities in 3 pilot districts after the conclusion of donor support in Ghana. Questionnaire and interview data from 42 people with disabilities, 8 local supervisors, and 3 social workers about program structures, support for people with disabilities, and challenges were analyzed using descriptive statistics and qualitative procedures, involving the use of Leximancer software. The authors found that some CBR structures remained in the communities. Diminished support for disabled peoples' organizations from communities and local government agencies were key challenges. The problem of volunteer local supervisors wanting to be paid ignited the evidence versus ideology debate around sustainability of CBR programs.

Ethics and Community-Based Rehabilitation: Eight Ethical Questions from a Review of the Literature

“…Project funding cycles are often short, leading to limited consideration of the longer term impact of projects and a lack of emphasis on sustainability. 20 Including a more comprehensive understanding of accountability in CBR programmes, one that also considers their impact on local communities and the experiences of community partners, is consistent with the broader community engagement approach underlying the CBR model. 46 …”

“…20 Community participation is crucial for CBR success, 17,18,49,50 but, to address concerns of exploitation and commit to fairness, programmes need to consider the distribution of burdens and benefits associated with volunteer efforts.…”

“…Through this process, we associated texts with partnerships among stakeholders, 3,5,6,16–29 respect for culture and local experience, 7,9,18,25,26,28,30–38 empowerment, 5,7–9,17–19,23,25,28,30,37,39–43 accountability, 2,5,8,9,17,20,21,23,24,27,30,34,36,40,42,44–47 and fairness in programme design. 10,11,17,18,20,27,28,30,40,48–58 During our analysis we also considered each topic area in relation to all of the collected texts. After critically appraising the collected literature, we then formulated eight questions that reflect sources of ethical tension, uncertainty, or debate related to CBR.…”

Meeting the Needs of Children and Families with Communication and other Developmental Difficulties in Accra, Ghana—An Assessment of the AwaaWaa2 Community-based Program

“…Reflective of the broader needs of the nation, staffing and training gaps stifle the ability of those on the ground to provide the quality of service they would like to. In a study of community-based organizations following the termination of international financial support, Kuyini et al (2011) recognized the challenges that these organizations faced in the absence of external funding. Some of the challenges include a heavy reliance on volunteer labor and diminished support from governmental entities.…”

Understanding the Research–Policy Divide for Oral Health Inequality

“…The technical aspects of the Bayesian-based Leximancer software have been explored in validity studies (Smith and Humphreys 2006) and in hundreds of applications (Baker et al 2011;Cretchley et al 2010;Hepworth and Paxton 2007;Hewett et al 2009;Kuyini et al 2011;Kyle et al 2008;Pakenham et al 2012;Travaglia et al 2009). The algorithm-based nature of Leximancer draws on the discipline of computational linguistics.…”