Role of CBR in Achieving MDGs

This week, we continue highlighting how Community Based Rehabilitation (CBR) can contribute towards the achievement of the Millennium Development Goals (MDGs), with a focus on goal number four, five and six, which we did not discuss last week.

Goal number four is on reducing child mortality. Mortality rates for children with disabilities are difficult to estimate. However, it has been suggested that they may be as high as 80 percent in countries where under-five mortality as a whole has decreased to below 20 percent. Children with disabilities are more at risk of dying, not only because of life threatening medical conditions or lack of access to health services, but also because in many cultures they are neglected or left to die.

CBR programmes can contribute to reducing child mortality by ensuring early identification of children with impairments and referral of children to specialised medical and rehabilitation services where required; providing disability awareness training to primary health care staff to ensure children with disabilities are able to access general healthcare; and providing basic home-based therapy interventions to promote child development.

Goal number five is improving maternal health. Millions of women around the world experience morbidity and disability as a result of pregnancy and childbirth complications. At the same time, women with disabilities can also become mothers themselves, and sometimes need particular consideration during pregnancy or when bringing up children. CBR can contribute to the improvement of maternal health by raising awareness within communities that people with disabilities have sexual and reproductive health needs; supporting women with disabilities to access maternal health services in their communities; and ensuring traditional birth attendant training programmes have a focus on disability.

Goal number six is on combating HIV/AIDS, malaria, and other disease. Infectious diseases are disabling. For example, HIV can cause blindness, neuropathy and dementia. At the same time people with disabilities also have as high or higher risk of contracting HIV.

Research conducted in Mozambique on disability and HIV found that one reason people with disabilities are routinely excluded from HIV and AIDS policies and programmes is a refusal or reluctance to acknowledge their sexuality. CBR can contribute to combating disease by reducing the stigma surrounding sexuality and people with disabilities; promoting the provision of health information to be available in accessible formats; and developing tailored prevention programmes for people with disabilities where mainstream programmes are inappropriate and ineffective.

CBR programmes can work with Disabled People’s Organisations (DPOs) to develop appropriate education methods to inform people with visual impairment about HIV/AIDS, as well as to inform health care services about the specific needs of this group. The African Blind Union produced a “train the trainer” manual on HIV/AIDS to facilitate the inclusion and participation of blind and partially sighted people in HIV/AIDS education programmes.