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Sustainability Criteria for CBR Programmes – Two Case Studies of Provincial Programmes in Vietnam


D M Mijnarends ,

Department of Health Services Research, - Focusing on Chronic Care and Ageing - Duboisdomein 30, 6229 GT Maastricht, Room 0.034, P.O. Box 616, 6200 MD Maastricht, NL
About D M
Donja Mijnarends received her Bachelor degree in Health Sciences at Maastricht University, the Netherlands, in 2009. In 2010 she graduated in International Public Health at VU University Amsterdam.
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D Pham,

Medical Committee Netherlands, VN
About D
Dung Pham graduated with a medical degree (General Practitioner) from Hanoi Medical University (Vietnam). He gained a Master degree in Public Health from the Hanoi School of Public Health (Vietnam). He worked for 6 years in clinical medicine before joining the Medical Committee Netherlands-Vietnam, a Dutch NGO, in 2004. He has mainly focused on support of people with disabilities, especially through community-based rehabilitation. He is a member of the National Rehabilitation Advisory Committee of Vietnam and a member of the scientific sub-committee of Vietnam Rehabilitation Association. His research interests are disability statistics, social inclusion and rehabilitation.
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K Swaans,

Athena Institute, VU University Amsterdam, NL
About K
Kees Swaans graduated in agricultural sciences from Wageningen University, Netherlands, in 1994 and in Management of Agricultural Knowledge Systems from the same university in the year 2000. In 2008, he obtained a PhD in Innovation and Communication in Health and Life Sciences from the Athena Institute, VU University Amsterdam (the Netherlands). During his career he has worked for about 10 years in Africa and South East Asia on innovation in agriculture and health. Currently he is working as a scientist at the International Livestock Research Institute (ILRI) in Addis Ababa, Ethiopia.
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W H van Brakel,

Athena Institute, VU University Amsterdam, NL
About W H
Wim van Brakel holds a medical degree from Amsterdam University, an MSc in Epidemiology from the London School of Hygiene & Tropical Medicine and a PhD in Neuro-epidemiology from Utrecht University. Dr. van Brakel has worked for 17 years in Nepal and India for international NGOs, specializing in leprosy control, prevention of disabilities, rehabilitation and research. He joined the Royal Tropic Institute (KIT), Amsterdam, as Senior Adviser Public Health in 2003. In 2008, he joined the Athena Institute, VU University Amsterdam, in a part-time capacity, teaching and researching in the field of disability and development. His research interests include peripheral neuropathy in leprosy, disability and rehabilitation, social participation, stigma and clinimetrics.
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E P Wright

Medical Committee Netherlands, VN
About E P
Pamela Wright received a PhD in medical biology in 1975 at Ottawa University, Canada, then did postdoctoral work in Italy (immunogenetics) and the Netherlands (infectious diseases) before moving to international health. As coordinator of international master courses in Immunology, Public Health and Biomedical Research Management at the University of Amsterdam and Royal Tropical Institute, she began to work with scientists in Vietnam in 1980. That turned into a long-term collaboration with Vietnam on medical education, public health research and health systems development. Since 1991, as Country Director of Medical Committee Netherlands-Vietnam, she has managed a range of programs in health and community development and maintained research interests in cooperation with Dutch and Vietnamese universities in community health including disability, mental health and HIV, and health systems including health economics and management.
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Purpose: This paper aims to explore the conditions needed for sustainable community based rehabilitation (CBR) programmes for persons with disabilities in Vietnam, and to identify the conditions and opportunities missing at present for the implementation of such programmes.

Method: Two CBR programmes in Vietnam, one medical based and one comprehensive (medical, educational, livelihood, social and empowerment), were evaluated for requirements and the current situation. Four factors were taken into account - human resources, organisational setting, social and political environment, and financing. Data were collected through interviews with programme managers and focus groups with stakeholders from provincial, district and communal levels, and with persons with disabilities. Persons with disabilities also completed a questionnaire to evaluate their satisfaction with the programme and their involvement in it.

Results: The conditions needed for a sustainable CBR programme were identified: availability of human resources, training, monitoring and evaluation, collaboration, commitment and financing. The conditions missing at present were: a stable pool of human resources (in both programmes), collaboration between sectors and with local authorities (in the medical programme), and knowledge about how to maintain financing (in both programmes). Persons with disabilities were more satisfied with their involvement in the comprehensive programme than in the medical programme. Stakeholders proposed opportunities to increase sustainability; highest priority was given to a collaboration plan (comprehensive CBR programme) and to involvement of other sectors in the CBR Steering Committee (medical CBR programme).

Conclusions: Few differences were found in conditions needed for sustainability of the medical and comprehensive programmes. The existence of disabled persons’ organisations (DPOs) seemed to be associated with the level of satisfaction persons with disabilities felt with their involvement in the programme.

Limitations: The People’s Committee was not involved in this research, although their input was perceived to be important. Generalisation of the results of this study should be done with caution because health system structures and organisational levels of CBR differ.

How to Cite: Mijnarends, D.M., Pham, D., Swaans, K., van Brakel, W.H. and Wright, E.P., 2011. Sustainability Criteria for CBR Programmes – Two Case Studies of Provincial Programmes in Vietnam. Disability, CBR & Inclusive Development, 22(2), pp.3–21. DOI:
Published on 15 Oct 2011.


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