Rehabilitation restores normal or near-normal function after illness, injury, addiction, or imprisonment, through retraining and medical treatment. Rehabilitation is crucial in comprehensive care, ideally starting at the moment a patient enters the healthcare system, with programs available in specialized hospital units or independent community centers.

1. Community Based
Rehabilitation
Presented by:
Harsh Rastogi,
Ph.D. Student,
AEC, PGIMER, Chandigarh
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2. Concept of Rehabilitation
Rehabilitation restores normal or
near-normal function after illness,
injury, addiction, or imprisonment,
through retraining and medical
treatment.

3. Introduction
• Rehabilitation is crucial in comprehensive care, ideally starting at the
moment a patient enters the healthcare system, with programs
available in specialized hospital units or independent community
centers.

4. Definition of Rehabilitation
• According to WHO “Rehabilitation is the combine and coordinate use
of the medical, social, educational, and vocational measures for
training and re-training the individual to the highest possible level of
functional ability”.
• Rehabilitation is a process of restoring people to useful functions in
physical, mental, social, economic and vocational area of their lives.

5. Objective of Rehabilitation
The four objectives of rehabilitation are:
• Restore abilities to the highest possible level.
• Prevent further disability or handicap.
• Protect existing abilities.
• Assist with present abilities.

6. Principles of
Rehabilitation
• Rehabilitation should start early, aiming to
restore independence and achieve pre-
illness/pre-disability function as quickly as
possible.
• It focuses on maximizing independence within
the limitations of the disability
• Setting goals based on patient assessment, and
• Involving the patient as an active participant.
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7. Principles of Rehabilitation
(Cont.)
• Daily activities are supported for
individuals with disabilities.
• Encouragement is given for dressing in a
way that boosts self-esteem and dignity.
• Motivation is provided to promote social
independence.
• Specific group needs are prioritized in
rehabilitation.
• Every patient has the right to receive
rehabilitation services.
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8. Scope of Rehabilitation
• Rehabilitation involves various disciplines
and specialties from different sectors.
• It has a broad scope due to the need for
collaboration across sectors.

9. Rehabilitation Team
Each member of the rehabilitation
team, including:
• Optometrists
• Physicians
• Nurses
• Physical trainers
• Physiotherapists
• Occupational therapist
• Speech therapist
• Vocational rehabilitation counsellor
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10. Rehabilitation Team
• Medical Social Worker
• Psychologist
• Dietician
• Recreational therapist
• Rehabilitation engineer and other
auxiliary staffs.
These must address the psychological,
biological, social, educational,
and vocational needs of the disabled
person.

11. Aspect of Rehabilitation
• Medical rehabilitation restores functions
through devices like prosthesis and artificial
limbs.
• Social rehabilitation restores family and
social relationships through family support
and integration.
• Educational rehabilitation provides
specialized training and facilities such as
Braille for the blind and sign language for
the deaf and mute.
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12. Aspect of Rehabilitation (Cont.)
• Psychological rehabilitation
enhances personal dignity and
confidence, fostering growth
and development in individuals.
• Vocational rehabilitation aims
to restore the ability to earn a
living through community
engagement and supportive
laws. The community should
offer job opportunities in
different sectors like shops and
factories.
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13. Nature of
Rehabilitation
Rehabilitation services can be
described based on their nature of
delivery. This may be of two types:
• Institutional based rehabilitation
• Community based rehabilitation

14. Institutional Based
Rehabilitation (IBR)
• Rehabilitation is conducted in various
settings, such as regional rehabilitation
institutes, district rehabilitation
centers, research rehabilitation
centers, and special educational
institutes for specific conditions like
deaf and dumb schools or schools for
children with intellectual disabilities.
• Rehabilitation can also take place in
specialized units within hospitals, such
as physiotherapy, speech therapy, or
vocational therapy centers.
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15. Community Based
Rehabilitation (CBR)
• WHO has introduced a new strategy to ensure
universal coverage of rehabilitation for all segments
of society.
• Community-Based Rehabilitation (CBR) is a unique
concept that emphasizes the active involvement of
people with disabilities, their families, and the
community in the rehabilitation process.

16. Community
Based Rehabilitation
(Cont.)
• CBR involves transferring knowledge and skills to
disabled individuals, their families, and the
community.
• Its primary focus is improving the quality of life for
people with disabilities and their families,
addressing basic needs, and promoting inclusion
and participation.
• CBR is a multisectoral approach with five major
components: health, education, livelihood, social,
and empowerment.
• It originated in the 1980s to provide community-
based rehabilitation using local resources, ensuring
access to rehabilitation for people with disabilities
in their own communities.
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17. Definition of CBR
• CBR may be defined as “strategy within
community development for the
rehabilitation, equalization of
opportunities, and social integration of all
people with disabilities."
• CBR is implemented through the
combined efforts of disabled people
themselves, their families and
communities, and the appropriate health,
education, vocational and social services”
- WHO
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18. Objective of CBR
• Identify all individuals with
disabilities in the
community.
• Provide necessary
rehabilitation services to
people with disabilities.
• Raise awareness about
disability-related issues.
• Transfer rehabilitation skills
to community members.
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19. Objective of CBR
(Cont.)
• Mobilize resources and raise
funds for addressing
the problem.
• Enhance community
participation to an optimal level.
• Ensure sustainability of the CBR
program until the needs
of disabled individuals are met.
• Prioritize services for disabled
children.

20. Principles of CBR
• Utilize available community resources effectively.
• Transfer knowledge and rehabilitation skills to
individuals with disabilities, their families, and the
community.
• Involve the community in planning, decision-
making, and evaluation.
• Strengthen referral services at district, provincial,
and national levels.
• Coordinate efforts among education, health, and
social systems.

21. Components of
CBR
• Foster a positive attitude towards people with
disabilities.
• Provide education and training opportunities.
• Deliver rehabilitation services, such as physical
therapy and occupational therapy.
• Create income-generating opportunities at
micro and macro levels.
• Establish care facilities.
• Focus on preventing the causes of disabilities.
• Conduct monitoring and evaluation.
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22. Advantage of CBR
Home-based
approach.
Cost-effective
measures.
Utilization of existing
community response
and resources.
Emphasis on quality
over quantity.
Adopting multiple
approaches tailored to
community needs.

23. Ethical Issues in
Rehabilitation
HCWs
• Rehabilitation healthcare
workers often face
unresolved issues for
which immediate answers
may not be readily
available.
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24. Ethical Issues
in Rehabilitation HCWs
(Cont.)
Important examples of ethics areas likely
to create conflict are listed below:
• Care of vulnerable populations, such
as the elderly, prisoners, children, and
cognitively impaired populations.
• Ethical considerations surrounding
advancements in death certification
technology.
• Controversies regarding assisted
suicide legislation and related
movements.
• Debates over individual rights to life
and the right to die.
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25. Ethical
Issues in Rehabilitation HCWs (Cont.)
• Ethical dilemmas in acute care medical
situations involving life and death decisions.
• Resource allocation and patient selection issues.
• Ethical concerns related to team care and goal
setting in rehabilitation medicine.
• Ethical questions about the appropriateness of
CBR as a rehabilitation strategy in developing
countries.

26. Rehabilitation
Council of India
• The Rehabilitation Council of India (RCI) was established as a registered
society in 1986.
• In September 1992, the RCI Act was enacted by Parliament, making it a
statutory body on June 22, 1993.
• The Act was later amended in 2000 to broaden its scope.
• The specific role of RCI is to develop, standardize, and regulate training
programs and courses in the field of Rehabilitation and Special Education at
various levels.
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27. Categories of professionals/personnel
The RCI Act covers the following 16
categories of professionals/personnel:
• Rehabilitation psychologists
• Rehabilitation social workers
• Rehabilitation counsellors
• Rehabilitation administrators
• Rehabilitation special educators
• Rehabilitation speech and hearing
professionals
• Rehabilitation prosthetic and orthotic
professionals
• Rehabilitation orientation and mobility
professionals
• Rehabilitation vocational trainers
• Rehabilitation physiotherapists
• Rehabilitation occupational therapists
• Rehabilitation medical practitioners
• Rehabilitation nurses
• Rehabilitation pharmacists
• Rehabilitation technicians
Any other professionals or personnel as
notified by the RCI.

28. Role of Community
Optometrist in
Rehabilitation
The role of a community optometrist in rehabilitation
includes:
• Assessing and diagnosing eye conditions that
require rehabilitation.
• Prescribing and providing suitable visual aids.
• Offering vision therapy and exercises.
• Collaborating with other healthcare professionals.
• Educating and supporting patients and their
families.
• Monitoring and evaluating the progress of
rehabilitation.
• Referring patients to specialized services and
community resources.
• Advocating for accessibility and inclusion.
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29. Additional
qualities for
community
optometrist in
rehabilitation
The qualities of a community optometrist in rehabilitation include:
• Excellent listening skills.
• High-level counseling abilities.
• Exceptional problem-solving skills.
• The ability to adopt innovative methods to help patients achieve their goals.
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30. Important areas
in optometry role
The key aspects of community involvement in rehabilitation
are:
• Creating awareness of the issue within the community.
• Educating families and the community about early
detection of disabilities.
• Providing early intervention services to address disabilities
promptly.
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31. Community involvement in
rehabilitation
The focus of community involvement in rehabilitation
includes:
• Ensuring an adequate supply of aids and workshops
for fabricating assistive devices.
• Implementing need-based rehabilitation programs.
• Training families in functional rehabilitation.
• Addressing and modifying negative attitudes of
families and the community towards disability.
• Facilitating meetings between families with
children having similar disabilities for mutual
support.
• Providing recreational facilities for disabled
children.
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