United Nations agencies defined Community Based Rehabilitation (CBR) in the 1970s as a strategy to increase access to rehabilitation services in resource constrained settings . This definition expanded with the publication of the Joint Position Paper (ILO, UNESCO, WHO) in 2004, which defined CBR as “a strategy within general community development for the rehabilitation, equalization of opportunities and social inclusion of all people with disabilities”.
In 2010 the CBR Guidelines were published (WHO, ILO, UNESCO, IDDC) . These Guidelines, based on the Joint Position Paper and DPO and practitioner experience of the approach, reflected the principles of the Convention on the Rights of Persons with Disabilities (CRPD) and outlined a cross-disability, multi-sectoral and rights-based approach aimed at achieving community based inclusive development (CBID). From this point of time, practitioners and DPOs have increasingly embraced CBID as a more accurate reflection of the approach.
CBID is no longer viewed as only a rehabilitation/health sector response, but as an approach which cross cuts multiple sectors and subsequently requires multi-sectoral engagement and coordination. This transition from CBR to CBID has not been immediate and the terms CBR and CBID are frequently used interchangeably, which can be confusing. Programs and initiatives implementing the approach, however, can be seen to be located along a continuum of work from rehabilitation services in constrained settings to multi-sectorial, rights-based programs which work with others to achieve inclusive community development.
Community based inclusive development (CBID) practice focuses on the creation of inclusive societies where people with disability have access to social and development benefits like everyone else in their communities. The rationale is that no one should be excluded from development for any reason, and that the inclusion of marginalized people in development processes reduces poverty, builds community resilience and benefits the whole of society. Together people analyse and address the issues that contribute to inclusive development in their community.
The backbone of implementing CBID is community mobilization. Community mobilization is a process in which action is stimulated by the community itself, or by facilitator(s) and that is planned, carried out, and evaluated by community individuals, groups, and organizations on a participatory and sustained basis.
Its implementation varies based on the context in which it operates but commonly addresses priority areas ensuring:
- Proactive communities: CBID works from the ‘bottom’ up, using participatory processes communities enable the spaces for self- empowerment to take place so that people with disabilities can exercise their rights. Its practice is transformative and dynamic.
- Inclusive systems at local level: CBID ensures local services and programmes (both mainstream and disability-specific) are accessible, available, affordable and high quality. Local government and other duty bearers are being advocated to, supported and held accountable for strengthening inclusive quality systems at the community level, such as health, education, social, transport, and livelihoods.
- Appropriate individual support: CBID ensures that persons with disabilities and their families have capacity and confidence and are provided support to actively participate in family and community life. This includes the strengthening of peer support functions, local self-help groups and DPOs, as well as access to specific support, such as early intervention, rehabilitation, personal assistance or assistive devices.
- Non-discrimination: CBID promotes and safeguards the voice, choice, dignity and autonomy of people with any type of disability. This includes working proactively on stigma and prejudice reduction and advocating for equality.
See also: Assistive devices, Introduction to disability and development, Health, Education, Livelihoods, Participation of persons with disabilities