Community Based Inclusive Development (CBID)

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

CBM (2019) Community Based Inclusive Development: A global overview

This web page provides links to infographics that explain Community Based Inclusive Development, and an overview of its key features. Five case studies explain how CBID looks different according to different country contexts - given differences in legislative frameworks, national coordination, poverty levels, and civil society engagement. Country case studies from: Philippines, Cameroon, Nicaragua, Papua New Guinea, India

WHO and Swedish Organizations of Disabled Persons International Aid Association (2002) Community-Based Rehabilitation as we have experienced it... voices of persons with disabilities: Part 1

Together with Part 2, these documents report studies conducted in Ghana, Guyana and Nepal on the impact of CBR on quality of life of persons with disabilities. They identify the CBR initiatives perceived as being the most useful. This study provides an illustration in promoting CBR as a strategy for empowering persons with disabilities and community-based development for CBR program managers, development organisations and for organisations involved in evaluating CBR programs.

WHO and Swedish Organizations of Disabled Persons International Aid Association (2002) Community-Based Rehabilitation as we have experienced it... voices of persons with disabilities: Part 2

Part 2 of the study provides country profiles from Ghana, Guyana and Nepal.

Humanity & Inclusion Source: Key list resources on community based rehabilitation

This key list includes introductory resources on CBR, implementation manuals, as well as evaluations and case studies of CBR implementation in many different contexts.

World Health Organization (2010) CBR and Millennium Development Goals

With the growing recognition that Millennium Development Goals (MDGs) are not achievable without involving persons with disabilities, this short document examines how CBR can be a strategy to contribute to the achievement of MDGs. It suggests activities that can be undertaken in CBR programs to support the 8 objectives of MDGs.

World Health Organization (2010) Community-based rehabilitation guidelines

The CBR Guidelines have been developed in a participatory approach by UN Agencies (WHO, the International Labour Organization, the United Nations Educational, Scientific and Cultural Organization), non-government organisations (such as CBM and Handicap International) and disabled people’s organisations (DPOs). The guidelines focus on key domains of universal well-being: health, education, livelihood, social life and empowerment, which are represented in a matrix. They provide guidance in planning and implementation of CBR programs, and promote CBR as an inclusive development strategy to improve quality of life and empower people with disability and their families. These guidelines are not prescriptive but provide strategies and examples to promote and illustrate a practical approach for CBR. This resource has been designed for implementing partners, particularly program managers/officers within international development agencies. It is also useful for organisations involved in program review and interactions with implementing partners.

World Health Organization (2012) Community-based rehabilitation: Promoting ear and hearing care through CBR

This document introduces key concepts of hearing loss such as causes and its impact on life and management of hearing loss. In addition it provides activities that can be undertaken under each component of the CBR matrix for implementing ear and hearing care within CBR programs. This document is useful for training CBR workers, DPOs and NGOs working in CBR programs. It is also useful for organisations involved in program review and interactions with implementing partners.

ILO/UNESCO/WHO (2004) CBR: A strategy for rehabilitation, equalization of opportunities, poverty reduction and social inclusion of people with disabilities (Joint Position Paper 2004)

This paper is a revision of the agencies’ 1994 joint position paper. It promotes CBR as a strategy for community development and encourages participation of persons with disabilities in planning and implementation of CBR programs. It promotes multi-sectoral collaboration for CBR to reach different community groups. Following this joint position paper, new CBR guidelines were developed to support planning and implementation of CBR programs. This document is useful for development agencies to understand the link between CBR and community development, and the context in which the CBR guidelines emerged.

Disability, CBR & Inclusive Development (DCID)

Formerly known as Asia Pacific Disability and Rehabilitation Journal, this is an open access peer-reviewed journal on CBR around the world. Four volumes a year are published. Its focus is evidence-based information to address needs of practitioners (particularly those from developing countries), policy makers, organisations of persons with disabilities and the scientific community.

World Health Organization and International Federation of Anti-Leprosy Associations (ILEP) (2007) Technical guide on community-based rehabilitation and leprosy

This manual provides guidance for leprosy management in CBR programs in line with the CBR matrix. This is a technical guide, providing activities/tasks for program managers and CBR workers to undertake several activities related to involving communities, advocacy, interventions for leprosy, forming self-help groups and empowering people with disability and their families. The manual was intended to be used by managers, trainers and supervisors in leprosy control or rehabilitation programs to implement CBR programs. While the manual is focused on leprosy, the recommended activities can also be used for other impairments. It is also useful for organisations involved in program review and interactions with implementing partners.

This document details what we learnt about good practice when working with people with disabilities in Community-Based Inclusive Development (CBID) programs, from a meta-evaluation that reviewed 33 evaluations from our international projects over four years.

Since 2015, CBM Australia has tracked how the economic situation of people with disabilities and their families in rural India has changed, as a result of our Community Based Inclusive Development project. Here’s what we found. The study showed that not only are people with disabilities more accepted and active in their community, their access to a variety of income sources has improved. While Covid-19 has impacted on that in the previous two years, people with disabilities and their families felt they were more on the same level as other households in their villages. This was a significant change compared to the preceding six years, when work with them begun.

There are no video link available

Picture of a girl from Tanzania who is sitting in a wheelchair fitted with a tray table outside a building.  She is smiling at the female CBR worker who is squatting beside her to her right. Her mother is squatting down in front of her adjusting a strap holding the child’s right foot in place on the wheelchair foot support.

Photo: Tobias Pflanz, 2010

Mary* (middle, aged 10) lives on the slopes of Mount Kilimanjaro in Tanzania. Janeth (right) is a CBR worker who visits Mary twice a month to see her development and give advice to her mother. Mary is really pleased with her new wheelchair which was provided through the CBR program and now has greater mobility. Today she can attend a pre-school, is learning figures and writing. Community Based Rehabilitation is a holistic approach that addresses health, education, livelihoods, social inclusion and empowerment of persons with disabilities. (*Pseudonym used) Copyright: CBM