Evaluation of Community Based Rehabilitation Programs in the North and Gaza Governorates
Soad Jameel S. Radwan
سعاد جميل رضوان
Community Based Rehabilitation (CBR) is a specific and important strategy for people with disabilities. This study aims to evaluate the CBR programs in Gaza and North Gaza governorates inorder to provide information that could contribute to support the services delivery and enhance the effectiveness of the programs to disabled persons. Evaluative techniques including triangulation methods combining both qualitative and quantitative techniques were conducted at the National Society for Rehabilitation and Palestinian Medical Relief Society. A sample of 300 beneficiaries have been chosen through a systematic random sample, and participated through a self-constructed interviewed- questionnaire with a response rate of 69.7%. Also, 10 key informants have been selected purposively for interview. In addition to that, 20 medical files were reviewed randomly. The study results revealed the main causes of disability are acquired in 71.6% of cases with various types, mainly accidents that constituted (52.1%), followed by communicable diseases (16.7%), and wars (14.6%). Among disability types, physical disability is the commonest one that formed 76.1%. The prominent services were relief aids (42.8%), followed by assistive devices (28.6%) and physiotherapy (27.1%). There was lack in livelihood domain where vocational training forms only (0.5%), and lack of the income generation and disabled people employment, while the majority (80.6%) of disabled live under the poverty line. The results indicated that 50.3% of visits are less than one visit monthly. Regarding the services provision, there is no difference between males and females. The researcher show that CBR programs are effective, this was elicited from response of the most of disabled’s needs, and improvement in disabled physical health status (P value 0.001), and psychological state (P value 0.001). At the same time, positive proportional correlation was found between the provided services scores and improvement of quality of life domains that contained indicators like feeling security, satisfaction, change in physical and psychological health state and social participation of disabled people (Pearson correlation 0.376 - P value 0.001). The study reflected good networking with different sectors, but governmental collaboration with CBR programs is still weak. On the other hand, communication and interaction of rehabilitation workers with disabled people was cooperative. The limited number of the rehabilitation workers and lack of volunteers increased the workload, and affect work’s process and quality. The study revealed shortage in the documentation and cases evaluation, poor public awareness about disability issues, and weak of the community ownership. Furthermore, application of the disability law number 4-1999 is inactive. This was indicated through the absence of disabled self- advocacy, and lack of the governmental role in maintaining disabled rights. The study provided a set of recommendations that could strengthen the CBR programs including; establishment of a national strategy aiming to create public awareness about the disability issues, and formulating of a local committee for developing polices, empowering the disabled role in the community, enhancing the voluntary work, and developing of staff capacity.