Monday, January 9, 2023, 15:00 - 16:30 CET
Presenter: Jean-Francois Trani, Brown School, University of Washington in St. Louis

The United Nations Convention on the Rights of Persons with Disabilities (UNCRPD), ratified in 2006, states that the achievement of equal rights, empowerment, and social inclusion of people with disabilities requires comprehensive rehabilitation services involving educational, social, economic, and medical interventions, all dimensions of the World Health Organization Community based rehabilitation (CBR) matrix. CBR programs aim at achieving those goals. In the present study, we investigated whether a large scale CBR program is improving (i) achievement of health, education, livelihood, empowerment and social inclusion; (ii) access to multiple services (namely physical therapy, assistive technology, education, employment, advocacy, and community awareness) and (iii) satisfactions (by measuring the reduction in unmet needs) of people with disabilities.

We enrolled in the study 1861 newly recruited CBR participants with disabilities from 169 villages between July 2012 and December 2013, and 1132 controls screened with disabilities randomly selected with a two-stage process within 6000 households from 100 villages in the same provinces as the CBR but outside its catchment area. Using propensity score matching (PSM) and difference in difference analysis, we estimated the differences in all the dimensions of the CBR program, accessing services and satisfaction. There were statistically significant differences between participants and controls on all outcomes between the baseline and endline. Our study indicates that a CBR program may be an effective way to achieve positive rehabilitation outcomes, improve overall well-being and provide services for persons with disabilities even in a conflict context such as Afghanistan. It contributes to addressing the longstanding question whether CBR, despite limited resources, may improve the rehabilitation and overall well-being of persons with disabilities, even in a conflict context, and whatever their impairment, individual characteristics and the CBR matrix components considered.