A 10-Year Literature Review of the Impact of CommunityBased Rehabilitation

Bob Bowers, Pim Kuipers, Pat Dorsett


A thematic literature review of the impact of CommunityBased Rehabilitation (CBR) in low to middle-income countries was conducted. The review covered the period from 2002 to 2012, and the CBR Matrix was utilised to provide structure for the evidence. Seven studies that investigated the impact of CBR interventions in developing countries were included. A modified harvest plot was used to summarise the strength and nature of evidence provided in relation to the CBR Matrix. Quantitative studies tended to focus on the Health domain, while qualitative studies generally focussed on the Social and Empowerment domains. No evidence of CBR impact was found in the Education domain, and very little evidence was found pertaining to Livelihood. Overall, the evidence base related to the impact of CBR remains limited, both in terms of quantity and robustness of design.


CBR matrix; evidence

Full Text:



Bekker G (2011). Measuring the effectiveness of community based rehabilitation services in children with developmental delays in the Dominican Republic. Available at: http://us.internationalchildcare.org/sites/internationalchildcare.org/files/attachments/trudy_article.pdf.

Biggeri M, Deepak S, Mauro V, Trani J-F, Kumar J, Ramasamy P, Bakhshi P, Giriyappa R (2012). Impact of CBR: impact of community-based rehabilitation programme in Karnataka India, Bologna, Italy: Italian Association Amici di Raoul Follereau (AIFO). Available at: http://www.aifo.it/english/proj/research/sparkcbr/attachments/MandyaCBR_phase01_research_light_version.pdf.

Chappell P, Johannsmeier C (2009). The impact of community based rehabilitation as implemented by community rehabilitation facilitators on people with disabilities, their families and communities within South Africa. Disabil Rehabil; 31(1): 7–13. http://dx.doi.org/10.1080/09638280802280429 PMid:19194807

Critical Appraisal Skills Programme – CASP (2010). Making sense of evidence about clinical effectiveness: 10 questions to help you make sense of qualitative research. Critical Appraisal Skills Programme (CASP). Available at: http://www.casp-uk.net/wp-content/uploads/2011/11/CASP_Qualitative_Appraisal_Checklist_14oct10.pdf.

Eide AH (2006). Impact of community-based rehabilitation programmes: The case of Palestine. Scandinavian Journal of Disability Research; 8(4): 199–210. http://dx.doi.org/10.1080/15017410500466750

Finkenflügel H (2004). Empowered to differ: stakeholders' influences in community-based rehabilitation. Rotterdam: Vrije Universiteit. Available at: www.enablement.nl/pdf/empoweredtodiffer.pdf.

Finkenflugel H, Wolffers I, Huijsman R (2005). The evidence base for community-based rehabilitation: a literature review. Int J Rehabil Res; 28(3): 187–201. Available at: http://www.ncbi.nlm.nih.gov/pubmed/16046912. http://dx.doi.org/10.1097/00004356-200509000-00001 PMid:16046912

Grut L, Hjort P, Eide A (2004). More of the same and try something new. Evaluation of the CBR programme in Eritrea, SINTEF. Available at: http://www.afri-can.org/CBRInformationinMatrix/EMPOWERMENT/EvaluationofCBRinEritrea.pdf.

Gulati S, Paterson M, Medves J, Luce-Kapler R (2011). Adolescent group empowerment: group-centred occupations to empower adolescents with disabilities in the urban slums of North India. Occupational Therapy International; 18(2): 67–84. http://dx.doi.org/10.1002/oti.294 PMid:20690125

International Labour Organisation, United Nations Educational,Scientific and Cultural Organisation,& World Health Organisation (2004). CBR: a strategy for rehabilitation, equalisation of opportunities, poverty reduction and social inclusion of people with disabilities: joint position paper. International Labour Organisation, United Nations Educational, Scientific and Cultural Organisation, World Health Organisation. Available at: http://www.ncbi.nlm.nih.gov/pubmed/11034985.

Klugman J, Macmillan P (2011). Human Development Report 2011. Sustainability and Equity: A better future for all. Available at: http://hdr.undp.org/en/reports/global/hdr2011/download/

Lagerkvist B (1992). Community-based rehabilitation - outcome for the disabled in the Philippines and Zimbabwe. Disability and rehabilitation; 14(1): 44–50. http://dx.doi.org/10.3109/09638289209166427 PMid:1586761

Mays N, Pope C (2000). Qualitative research in health care: assessing quality in qualitative research. BMJ: British Medical Journal; 320(January): 50–52. http://dx.doi.org/10.1136/bmj.320.7226.50 PMid:10617534 PMCid:PMC1117321

Miles S (1996). Engaging with the disability rights movement: the experience of community-based rehabilitation in southern Africa. Disability & Society; 11(4): 501–518. Available at: http://search.proquest.com.libraryproxy.griffith.edu.au/docview/61569285?accountid=14543. http://dx.doi.org/10.1080/09687599627561

Mitchell R (1999). The research base of community-based rehabilitation. Disabil Rehabil; 21(10-11): 459–468. Available at: http://informahealthcare.com/doi/abs/10.1080/096382899297251. http://dx.doi.org/10.1080/096382899297369 http://dx.doi.org/10.1080/096382899297251 PMid:10579666

Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group (2009). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement.PLoS Med 6(6): e1000097. doi:10.1371/journal.pmed1000097

Ogilvie D, Fayter D, Petticrew M, Sowden A, Thomas S, Whitehead M, Worthy G(2008). The harvest plot: a method for synthesising evidence about the differential effects of interventions. BMC medical research methodology; 8(1): 8. http://dx.doi.org/10.1186/1471-2288-8-8 PMid:18298827 PMCid:PMC2270283

Patel S, Alavi Y, Lindfield R, Kuper H (2013). The impact of rehabilitative services in the lives of adults and children with disabilities, in low-income and middle-income countries: an assessment of the quality of the evidence. Disability and Rehabilitation; 35(9): 703–712. Available at: http://dx.doi.org/10.3109/09638288.2012.705949. http://dx.doi.org/10.3109/09638288.2012.705949

Robertson J, Emerson E, Hatton C, Yasamy M (2012). Efficacy of community-based rehabilitation for children with or at significant risk of intellectual disabilities in low and middle-income countries: a review. J Appl Res Intellect Disabil; 25(2): 143–154. http://dx.doi.org/10.1111/j.1468-3148.2011.00679.x http://dx.doi.org/10.1111/j.1468-3148.2011.00638.x

Savedoff W, Levine R, Birdsall N (2006). When will we ever learn? Improving lives through impact evaluation, Washington, D.C.: Centre for Global Development. Available at: papers2://publication/uuid/990BEF9C-47A1-4E4D-8C39-2617EE36716F. PMid:17175735

Thomas M, Thomas MJ (1999). A discussion on the shifts and changes in community based rehabilitation in the last decade. Neurorehabilitation and neural repair; 13(3): 185–189. http://dx.doi.org/10.1177/154596839901300308

Velema JP, Ebenso B, Fuzikawa PL (2008). Evidence for the effectiveness of rehabilitation-in-the-community programmes. Leprosy review; 79(1): 65–82. Available at: http://www.leprosy-review.org.uk/. PMid:18540238

White H (2010). A contribution to current debates in impact evaluation. Evaluation; 16(2): 153–164. http://dx.doi.org/10.1177/1356389010361562

World Health Organisation (2003). International consultation to review community-based rehabilitation (CBR). Helsinki: WHO Document Production Services. Available at: http://whqlibdoc.who.int/hq/2003/who_dar_03.2.pdf.

World Health Organisation (2008). Community based rehabilitation (CBR) Matrix (7/2/2014). Available at: http://www.who.int/disabilities/cbr/cbr_matrix_11.10.pdf.

World Health Organisation (2010). CBR Guidelines: introductory booklet C. Khasnabis & K. Heinicke Motsch, eds., Malta: World Health Organisation. Available at: http://www.who.int/disabilities/cbr/guidelines/en/index.html.

Yu JJ, Hu YS, Wu Y, Chen WH, Zhu YL, Cui X, Lu WB, Qi Q, Qu PY, Shen XH (2009). The effects of community-based rehabilitation on stroke patients in China: a single-blind, randomised controlled multicentre trial. Clinical rehabilitation; 23(5): 408–417. http://dx.doi.org/10.1177/0269215508091870 PMid:19349340

DOI: https://doi.org/10.5463/dcid.v26i2.425

Copyright (c) 2015 Bob Bowers, Pim Kuipers, Pat Dorsett

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Supported by:


© Disability, CBR & Inclusive Development