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Community-based rehabilitation for people with disabilities in low- and middle-income countries

Additional Info

  • Authors: Valentina Iemmi, Lorna Gibson, Karl Blanchet, Suresh Kumar, Santosh Rath, Sally Hartley, GVS Murthy, Vikram Patel, Joerg Weber, Hannah Kuper
  • Published date: 2015-09-01
  • Coordinating group(s): International Development
  • Type of document: Review, Plain language summary
  • Title: Community-based rehabilitation for people with disabilities in low- and middle-income countries
  • Library Image: Library Image
  • See the full review: https://onlinelibrary.wiley.com/doi/10.4073/csr.2015.15
  • Records available in: English, Hindi, Spanish
  • English:

    PLAIN LANGUAGE SUMMARY

    Positive effects from community-based rehabilitation for people with disabilities and their carers in low- and middle-income countries

    Community-based rehabilitation has a beneficial effect on the lives of people with disabilities in low- and middle-income countries.

    What is the review about?

    People with disabilities include those who have long-term physical, mental, intellectual or sensory impairments. The World Health Organization endorses community-based rehabilitation interventions as the strategy for addressing the needs of people with disabilities in low- and middle-income countries. There are an estimated one billion people with disabilities globally, of which 80% live in low- and middle-income countries.

    This Campbell systematic review looks at the evidence from different types of community- based rehabilitation interventions in low- and middle-income countries targeting different types of physical and mental disabilities, including stroke, arthritis, chronic obstructive pulmonary disease, schizophrenia, dementia and intellectual impairment.

    These interventions aim to enhance the quality of life of people with disabilities and their carers, by meeting 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.

    What is the aim of this review?

    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.

    What studies are included?

    Studies included in this review cover a wide range of client populations, interventions and outcomes. The primary focus of 14 of the interventions is health, and one intervention is focused on education. Other components of community-based rehabilitation are a minor focus in some of the studies.

    Only one study concerned children. Most of the interventions targeted both people with disabilities and their carers, although most of the studies evaluated the effect of the intervention on the people with disabilities only. The majority of studies were undertaken in Asia, particularly in China. One study was from South Africa. The review highlights the need for studies from Sub-Saharan Africa.

    What were the main findings of the review?

    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.

    What do the findings of this review mean?

    Each community-based rehabilitation programme is tailored to specific needs and settings. Furthermore, impact is measured in a variety of domains, including participation, quality of life and clinical outcomes. This means that establishing an evidence base for effectiveness of community- based rehabilitation is difficult.

    Economic evaluation, including cost effectiveness, is needed to understand whether resource allocation is appropriate given the challenges faced by low- and middle-income countries.

    To build stronger evidence, future studies will need to focus on broader client groups and include economic evaluations.

    How up-to-date is this review?

    The review authors searched for studies published between 1976 and 2012.

  • Spanish:

    Click on 'Download PDF' on the right to view the plain language summary in Spanish.

  • Hindi:

    Click on 'Download PDF' on the right to view the plain language summary in Hindi.

Select language:

PLAIN LANGUAGE SUMMARY

Positive effects from community-based rehabilitation for people with disabilities and their carers in low- and middle-income countries

Community-based rehabilitation has a beneficial effect on the lives of people with disabilities in low- and middle-income countries.

What is the review about?

People with disabilities include those who have long-term physical, mental, intellectual or sensory impairments. The World Health Organization endorses community-based rehabilitation interventions as the strategy for addressing the needs of people with disabilities in low- and middle-income countries. There are an estimated one billion people with disabilities globally, of which 80% live in low- and middle-income countries.

This Campbell systematic review looks at the evidence from different types of community- based rehabilitation interventions in low- and middle-income countries targeting different types of physical and mental disabilities, including stroke, arthritis, chronic obstructive pulmonary disease, schizophrenia, dementia and intellectual impairment.

These interventions aim to enhance the quality of life of people with disabilities and their carers, by meeting 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.

What is the aim of this review?

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.

What studies are included?

Studies included in this review cover a wide range of client populations, interventions and outcomes. The primary focus of 14 of the interventions is health, and one intervention is focused on education. Other components of community-based rehabilitation are a minor focus in some of the studies.

Only one study concerned children. Most of the interventions targeted both people with disabilities and their carers, although most of the studies evaluated the effect of the intervention on the people with disabilities only. The majority of studies were undertaken in Asia, particularly in China. One study was from South Africa. The review highlights the need for studies from Sub-Saharan Africa.

What were the main findings of the review?

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.

What do the findings of this review mean?

Each community-based rehabilitation programme is tailored to specific needs and settings. Furthermore, impact is measured in a variety of domains, including participation, quality of life and clinical outcomes. This means that establishing an evidence base for effectiveness of community- based rehabilitation is difficult.

Economic evaluation, including cost effectiveness, is needed to understand whether resource allocation is appropriate given the challenges faced by low- and middle-income countries.

To build stronger evidence, future studies will need to focus on broader client groups and include economic evaluations.

How up-to-date is this review?

The review authors searched for studies published between 1976 and 2012.

Library Image

See the full review

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