Project Proposal on C.B.R

THE ORIGINS OF COMMUNITYBASED REHABILITATION.

By Einar Helander MD, PhD

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Contents
1. Introduction
2. WHO policies in 1974
3. Estimation of the prevalence of disability
4. The 1974 WHO Policy document
5. WHO’s new Programme for disability prevention
6. WHO’s new Programme for community-based rehabilitation
Situation analysis.
Field studies
Community mobilization
Sustainability
Conclusions
7. Rehabilitation as a component of primary health care
8. Formulating and testing the technology
9. WHO adopts the new policy
10. Developing managerial tools
11.Financing CBR
12.Dealing with the resistance
13.CBR in the developed countries
14.Childhood violence and maltreatment
15.Media
16.The future of CBR
Refer ences

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This documents has been written at the r equest of the Disability and
Rehabilitation Programme at the World Health Organization, Hea dquarters,
Geneva, Switzer land

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THE ORIGINS OF COMMUNITY-BASED
REHABILITATION.
1. Introduction.
In 1973 Dr. Halfdan Mahler was elected Dir ector-General of the World Healt h
Organization. During 15 years he initiated a large number of new policies a nd programmes – a clear break with those that had governed WHO during his predecessors. Dr Mahler was deeply concerned a bout “the existing gross inequality in the health status of the people particularly between developed and developing countries as well as within countries; this was seen as politically, socially and economically unacceptable”1. Ther e wa s also a reaction against the health sector concentration on high-level hospital care, which at that time consumed some 90% of the health budgets in most developing countries.
The reality in the developing countries was that most populations, especially the rural poor ha d little or no access to a ny hea lth care. As an exa mple, when the author visited Cote d’Ivoir e a few years later ther e wer e three

References: 2. WHO Document: Disability Prevention and Rehabilitation. A29/INF/DOC/1, 1976. 3. WHO Technical Report Series 419, WHO Geneva, 1969. 4. Killarney expert meeting: The development of rehabilitation services in relation to available resources, International Society for Rehabilitation of the Disabled, 1969. 5. International Classification of Functioning, Disability and Health. WHO, Geneva, 2001. 6. Helander, E.: The World of the Defenseless. Under publication, 2007. UNDP New York, 1992, second edition 1999. 10. WHO Technical Report Series, 668, WHO, Geneva, 1981 11.Helander, E.: “Enquete economic a propos de la readaptation”, Readaptation, No C.I.P.E.S., Paris, France, 1979 12 perspective. Rehabilitation International, 1981 13 UNDP document. 1996, last edition, 2001. 14. Helander, E.: National Planning of Rehabilitation. UNDP document, 1992, last edition 2001 edition, 2001. 1994, last edition, 2001. 19. Jönsson, T.: Inclusive Education, UNDP, New York, 1996 20 R. Soc. Lond. B 209, p 129, 1980 Photo credits: World Health Organization, Star of Hope International, Sweden, and private