An Evaluative Study of Services Provided in Community-Based Rehabilitation Centres in Jordan
Purpose: This research study aimed to investigate the effectiveness of the services provided by CBR programmes in Jordan.
Method: This was a mixed-methods investigation. A survey was carried out with 47 participants (stakeholders and volunteers) from four CBR centres in Jordan. It comprised 18 questions that collected both qualitative and quantitative data with both closed- and open-ended questions. The quantitative data was analysed using SPSS Version 22.0. Qualitative data was analysed through thematic content analysis and open coding to identify emergent themes.
Results: 40.4% of the participants evaluated the effectiveness of CBR services as low. This mainly stemmed from the lack of efforts to increase the local community’s knowledge about CBR, disability and the role of CBR programmes towards people with disabilities.
Conclusions: A proposal was offered concerning the priorities of CBR programmes in Jordan. Efforts need to be directed at promoting livelihood and empowerment components in order to actualise the principles of CBR, mainly by promoting multispectral collaboration as a way of operation.
Implications: This study was inclusive of all types of disability. Barriers to the effectiveness of services may stem from accessibility issues to the families of persons with disabilities (hard to reach) or from CBR services themselves (hard to access). The culturally specific evaluative tool in this study was of “good” specificity and sensitivity, this evaluative instrument can be transferrable to measure the impact of CBR programmes in other settings.
Abbas A (1995). Surveying disabilities in Mafraq District in Jordan in view of approaching community based rehabilitation. The Journal Of The Egyptian Public Health Association; 70(5-6): 643-60. PMid:17214180
Adeoye A, Seeley J, Hartley S (2011). Developing a tool for evaluating community-based rehabilitation in Uganda. Disability and Rehabilitation; 33:1110–24. https://doi.org/10.3109/09638288.2010.521613. PMid:20929422
AlHeresh R, Bryant W, Holm M (2013).Community-based rehabilitation in Jordan: challenges to achieving occupational justice. Disability and Rehabilitation; 35(21): 1848–1852. https://doi.org/10.3109/09638288.2012.756944. PMid:23343361
Barrett H (2008). Hard to reach families engagement in the voluntary and community sector. London: Family and Parenting Institute.
Baum F (2008). The new public health. Melbourne, Australia: Oxford University Press. 
Boag-Munroe G, Evangelou M (2012). From hard to reach to how to reach: a systematic review of the literature on hard-to-reach families. Research Papers in Education; 27: 209–239. https://doi.org/10.1080/02671522.2010.509515
Boyce W, Ballantyne S (2000). Developing CBR through evaluation. Asia Pacific Disability Rehabilitation Journal; 2:69–83.
Byford J, Veenstra N, Gi S (2003). Towards a method for informing the planning of community-based rehabilitation in Papua New Guinea. Papua and New Guinea medical Journal; 46(1-2): 63-80. PMid:16450785
Coe C, Gibson A, Spencer N. et al. (2008). Sure start: voices of the 'hard-to-reach. Child: Care, Health and Development; 34: 447–453. https://doi.org/10.1111/j.1365-2214.2008.00816.x
Conklin J, Lusk E, Harris M, Stolee P (2013). Knowledge brokers in a knowledge network: the case of Seniors Health Research Transfer Network knowledge brokers. Implementation Science; 8: 7. https://doi.org/10.1186/1748-5908-8-7. PMid:23302517. PMCid:PMC3598713
Cornielje H, Velema JP, Finkenflugel H (2008). Community based rehabilitation programmes: monitoring and evaluation in order to measure results. Leprosy Review; 79:36–49. PMid:18540236
Cortis N (2012). Overlooked and under-served? Promoting service use and engagement among 'hard-to-reach' populations. International Journal of Social Welfare; 21: 351–360. https://doi.org/10.1111/j.1468-2397.2011.00825.x
Cushing P J (2003). Policy approaches to framing social inclusion and social exclusion: An Overview. Ontario, Canada: L'InstitutRoeher Institute, York University. Available from:http://www.philia.ca/files/pdf/SocialInclusion.pdf
Darawsheh W (2014). Reflexivity in research: promoting rigour, reliability and validity in qualitative research. International Journal of Therapy and Rehabilitation; 21: 560-568. https://doi.org/10.12968/ijtr.2014.21.12.560
Deepak S, Kumar J, Ramasamy P, Griffo G (2014). An emancipatory research on CBR and the barriers faced by persons with disabilities. Disability and Rehabilitation; 36(18):1502-1507. https://doi.org/10.3109/09638288.2013.800914. PMid:23763467
Dendumrongsup T, Plumb A, Halligan S, Fanshawe TR, Altman DG, Mallet S (2014). Multi-Reader Multi-Case Studies Using the Area under the Receiver Operator Characteristic Curve as a Measure of Diagnostic Accuracy: Systematic Review with a Focus on Quality of Data Reporting. PLoS One.
https://doi.org/10.1371/journal.pone.0116018. PMid:25541977. PMCid:PMC4277459
Emerson E, Hatton C (2007). The socio-economic circumstances of children at risk of disability in Britain. Disability & Society; 22: 563–580. https://doi.org/10.1080/09687590701560154
Finkenflugel H, Wolffers I, Huijsman R (2005). The evidence base for community-based rehabilitation: a literature review. International Journal of Rehabilitation Research; 28: 187–201. https://doi.org/10.1097/00004356-200509000-00001. PMid:16046912
Grandisson M, Hebert M, Thibeault R (2014a). A systematic review on how to conduct evaluations in community-based rehabilitation. Disability and Rehabilitation; 36: 265–275. https://doi.org/10.3109/09638288.2013.785602. PMid:23614357. PMCid:PMC3913006
Grandisson M, Thibeault R, Hebert M, Templeton A (2014b). Community based rehabilitation programme evaluations: lessons learned in the field. Disability, CBR & Inclusive Development; 25:55–71. https://doi.org/10.5463/dcid.v1i1.240
Grandisson M, Thibeault R., Hebert M, Cameron D (2016a). Expert consensus on best evaluative practices in community-based rehabilitation. Disability and Rehabilitation; 38(5): 499-510. https://doi.org/10.3109/09638288.2015.1044030. PMid:25959000
Grandisson M, Hebert M, Thibeault R (2016b). Practice guidelines for programme evaluation in community-based rehabilitation. Disability and Rehabilitation; 39(12):1243-1251. https://doi.org/10.1080/09638288.2016.1189604. PMid:27347694
Hajian-Tilaki K (2013). Receiver Operating Characteristic (ROC) Curve Analysis for Medical Diagnostic Test Evaluation. Caspian Journal of Internal Medicine; 4(2): 627-635. PMid:24009950. PMCid:PMC3755824
Higher Council for Affairs of Persons with Disabilities -HCD (2017). [Internet] Role of Rehabilitation in CBR (In Arabic). Available from: http://hcd.gov.jo/ar/content/%D9%85%D8%AD%D9%88%D8%B1-%D8%A7%D9%84%D8%AA%D8%A3%D9%87%D9%8A%D9%84-%D9%88%D8%A5%D8%B9%D8%A7%D8%AF%D8%A9-%D8%A7%D9%84%D8%AA%D8%A3%D9%87%D9%8A%D9%84-%D9%88%D8%A7%D9%84%D8%AE%D8%AF%D9%85%D8%A7%D8%AA-%D8%A7%D9%84%D9%85%D8%B3%D8%A7%D9%86%D8%AF%D8%A9
International Labour Organisation (ILO), United Nations Educational, Scientific and Cultural Organisation (UNESCO), World Health Organisation (WHO) (2004a). [Internet] Joint position paper. CBR: a strategy for rehabilitation, equalisation of opportunities, poverty reduction and social inclusion of people with disabilities. Geneva: WHO Press. Available from: http://www.who.int/ disabilities/cbr/en/
International Labour Organisation (ILO), United Nations Educational, Scientific and Cultural Organisation (UNESCO), World Health Organisation (WHO) (2004b). The CBR Matrix. Available from: http://www.who.int/disabilities/cbr/cbr_matrix_11.10.pdf
Lang R (2011). Community-based rehabilitation and health professional practice: developmental opportunities and challenges in the global North and South. Disability and Rehabilitation; 33:165–73. https://doi.org/10.3109/09638288.2010.487923. PMid:20500051
Layton N, Steel E (2015)."An Environment Built to Include Rather than Exclude Me": Creating Inclusive Environments for Human Well-Being. International Journal of Environmental Research and Public Health; 12:11146-11162. https://doi.org/10.3390/ijerph120911146 PMid:26371024. PMCid:PMC4586666
Lukersmith S, Hartley S, Kuipers P (2013). Community-based rehabilitation (CBR) monitoring and evaluation methods and tools: a literature review. Disability and Rehabilitation; 35: 1941–1953. https://doi.org/10.3109/09638288.2013.770078. PMid:23574396
Maharaj V, Rahman F, Adamson L (2014). Tackling child health inequalities due to deprivation: using health equity audit to improve and monitor access to a community paediatric service. Child: Care, Health and Development; 40: 223–230. https://doi.org/10.1111/cch.12011. PMid:23121388
Mauro V, Biggeri M, Deepak S, et al. (2014). The effectiveness of community-based rehabilitation programmes: an impact evaluation of a quasi-randomised trial. Journal of Epidemiology and Community Health; 68:1102–1108. https://doi.org/10.1136/jech-2013-203728. PMid:25194053
Petrenchik M (2008). Childhood Disability in the Context of Poverty. Hamilton, ON: CanChild Centre for Childhood Disability Research.
Phoenix M, Rosenbaum P (2014). Development and implementation of a paediatric rehabilitation care path for hard-to-reach families: a case report. Child: Care, Health and Development; 41(3):494–499. https://doi.org/10.1111/cch.12194. PMid:25251703
Ritchie J, Lewis J (2007). Qualitative Research Practice: A guide for Social Science Students and Researchers. London, UK: Sage publications.
Russell D, Rivard L, Walter S, Rosenbaum PL, Roxborough L, Cameron D (2010). Using knowledge brokers to facilitate the uptake of paediatric measurement tools into clinical practice: a before-after intervention study. Implementation Science; 5: 92. https://doi.org/10.1186/1748-5908-5-92 PMid:21092283. PMCid:PMC3004810
Seale C, Gobo G, Gubrium J, Silverman D (2007). Qualitative Research Practice. London (UK): Sage Publications.
Sen A (2009). The idea of justice. Cambridge, MA: The Belknap Press of Harvard University Press.
Thomas M (2011). Reflections on community-based rehabilitation. Psychology and Developing Societies; 23:277–291. https://doi.org/10.1177/097133361102300206
Valentine F (2001). Enabling citizenship: full inclusion of children with disabilities and their parents. Canadian Policy Research Network Discussion Paper No. F 13; 2001. Available from: http://www.cprn.org/ documents/3594_en.pdf
Waring J, Currie G, Crompton A, Bishop S (2013). An exploratory study of knowledge brokering in hospital settings: facilitating knowledge sharing and learning for patient safety? Social Science & Medicine; 98: 79–86
Winkworth G, McArthur M, Layton M, Thomson L, Wilso F (2010). Opportunities lost – why some parents of young children are not well-connected to the service systems designed to assist them. Australian Social Work; 63:431–444. https://doi.org/10.1080/0312407X.2010.508170
World Bank (2016). The 2016 edition of World Development Indicators is out: three features you won't want to miss. Available from: http://blogs.worldbank.org/opendata/2016-edition-world-development-indicators-out-three-features-you-won-t-want-miss
World Health Organisation (WHO), International Disability and Development Consortium (IDDC) (1996). Guidelines for conducting, monitoring and self assessment of community-based rehabilitation programmes: using evaluation information to improve programmes. Geneva, Switzerland. Available from: http://www.who.int/disabilities/publications/cbr/en/
World Health Organisation (WHO), United Nations Educational, Scientific and Cultural Organisation (UNESCO), International Labour Organisation (ILO), International Disability and Development Consortium (IDDC) (2010). Community-based rehabilitation: CBR guidelines. Geneva, Switzerland: WHO, UNESCO, ILO, IDDC.
World Health Organisation, World Bank (2011). World Report on Disability. Geneva: WHO Press.
Zaidi A, Burchardt T (2005). Comparing incomes when needs differ: equiualisation for the extra costs of disability in the U.K. Review of Income Wealth; 51(1):89–114. https://doi.org/10.1111/j.1475-4991.2005.00146.x
Zhao T, Kwok J (1999). Evaluating community-based rehabilitation: guidelines for accountable practice. Available from: www.dinf.ne.jp/doc/english/resource/z00021/z0002101. html#contents
- There are currently no refbacks.
Copyright (c) 2018 Wesam B. Darawsheh
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
© Disability, CBR & Inclusive Development