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CBR in Afghanistan

CBR in Afghanistan. Jenny Wickford PhD RPT. CBR in Afghanistan. CBR in Afghanistan. Different NGOs have been running CBR since early 1990s, by various different NGOs. CBR in Afghanistan. Different NGOs have been running CBR since early 1990s, by various different NGOs

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CBR in Afghanistan

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  1. CBR in Afghanistan Jenny Wickford PhD RPT

  2. CBR in Afghanistan

  3. CBR in Afghanistan • Different NGOs have been running CBR since early 1990s, by various different NGOs

  4. CBR in Afghanistan • Different NGOs have been running CBR since early 1990s, by various different NGOs • CBR is implemented in 16 / 34 provinces

  5. CBR in Afghanistan • Different NGOs have been running CBR since early 1990s, by various different NGOs • CBR is implemented in 16 / 34 provinces • Often include service provision (eg physiotherapy and assistive devices) since the government has not been able to do this

  6. CBR in Afghanistan • Different NGOs have been running CBR since early 1990s, by various different NGOs • CBR is implemented in 16 / 34 provinces • Often include service provision (eg physiotherapy and assistive devices) since the government has not been able to do this • Undergoing change – unsure about what will happen in future

  7. CBR in Afghanistan • Different NGOs have been running CBR since early 1990s, by various different NGOs • CBR is implemented in 16 / 34 provinces • Often include service provision (eg physiotherapy and assistive devices) since the government has not been able to do this • Undergoing change – unsure about what will happen in future • Rehabilitation of Afghans with Disabilities (RAD) – largest disability programme in the country

  8. Rehabilitation of Afghans with Disabilities Geographical spread

  9. Rehabilitation of Afghans with Disabilities

  10. Rehabilitation of Afghans with Disabilities • 5 different components • Special and inclusive education • Information, education, communication • Vocational training and revolving loans • Physiotherapy • Orthopaedic workshops

  11. Physiotherapy component

  12. Physiotherapy component • Institution-based services

  13. Physiotherapy component • Institution-based services • ‘Home-Based Training’

  14. Physiotherapy component • Institution-based services • ‘Home-Based Training’ • Community-based physiotherapy?

  15. Community-based health services? • Goal of CBR in relation to health: that “people with disabilities achieve their highest attainable standard of health” (WHO, CBR Guidelines, Health Component, 2010).

  16. Community-based health services? • Goal of CBR in relation to health: that “people with disabilities achieve their highest attainable standard of health” (WHO, CBR Guidelines, Health Component, 2010). • Thus, what is the role of a physiotherapist, occupational therapist or nurse in a CBR programme? An orthopaedic technician?

  17. Community-based health services? • Goal of CBR in relation to health: that “people with disabilities achieve their highest attainable standard of health” (WHO, CBR Guidelines, Health Component, 2010). • Thus, what is the role of a physiotherapist, occupational therapist or nurse in a CBR programme? An orthopaedic technician? • DISCUSSION

  18. Community-based health services? • Role of CBR in relation to health: “to work closely with the health sector to ensure that the needs of people with disabilities and their family members are addressed in the areas of health promotion, prevention, medical care, rehabilitation and assistive devices. CBR also needs to work with individuals and their families to facilitate their access to health services and to work with other sectors to ensure that all aspects of health are addressed” (WHO, CBR Guidelines, Health Component, 2010).

  19. Community-based health services? • Technical expertise as part of a referral system is essential for CBR programmes to function: “If following the basic assessment, CBR personnel identify a need for specialized rehabilitation services, e.g. physiotherapy, occupational therapy, audiology, speech therapy, they can facilitate access for people with disabilities by initiating referrals” (WHO, CBR Guidelines, 2010)

  20. Community-based health services? • Technical expertise as part of a referral system is essential for CBR programmes to function: “If following the basic assessment, CBR personnel identify a need for specialized rehabilitation services, e.g. physiotherapy, occupational therapy, audiology, speech therapy, they can facilitate access for people with disabilities by initiating referrals” (WHO, CBR Guidelines, 2010) • For eg, physiotherapists with a particular community focus – community or community-based physiotherapists • Require additional skills • Not just home-based treatment! Work with education, advocacy and awareness, lobbying, collaboration with other professionals etc

  21. Community-based health services? • In Afghanistan, physiotherapy and orthopaedic technicians were included by necessity, since these services are not sufficiently available within the national health-care structures.

  22. Community-based health services? • In Afghanistan, physiotherapy and orthopaedic technicians were included by necessity, since these services are not sufficiently available within the national health-care structures. • Present challenge – to shift physiotherapy in national healthcare structures • Salary issues • Technical support challenges • Status • Less recognition of the profession within national healthcare structure

  23. Community-based health services • Present developments 2011 • Expanding the training, to specifically train physiotherapists for the national healthcare structure • Adapting the present 3-year curriculum to strengthen referral system and collaboration between relevant health professionals, to strengthen links with communities, and to raise awareness of rehabilitation services

  24. Community-based health services • Present developments 2011 • Expanding the training, to specifically train physiotherapists for the national healthcare structure • Adapting the present 3-year curriculum to strengthen referral system and collaboration between relevant health professionals, to strengthen links with communities, and to raise awareness of rehabilitation services • Future possibilities • Institution-based physiotherapists + community physiotherapists

  25. Community-based health services • Present developments 2011 • Expanding the training, to specifically train physiotherapists for the national healthcare structure • Adapting the present 3-year curriculum to strengthen referral system and collaboration between relevant health professionals, to strengthen links with communities, and to raise awareness of rehabilitation services • Future possibilities • Institution-based physiotherapists + community physiotherapists • Huge challenge: to move away form dependency on NGOs as services are moved into government structures

  26. tashakor

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