TRAINING OF PERSONNEL FOR CBR
DISCUSSION LED BY :
Dr. C.M Francis
CBR Forum, 38, 11th Main, 100 Ft (Ring) Road, BTM Layout 1st Stage
Bangalore - 560 029 ,India
Ph: 6684218
The need for a new cadre of worker in the rehabilitation field, namely community rehabilitation worker (CRW), was advocated by WHO in 1981. The major difference described between other forms of rehabilitation and CBR was that in the latter, the needs of people with disabilities are met in their own environment, involving family members and the community. More or less at the same time it was suggested that for rural health care services, use of highly trained health professionals is ineffective in addressing the magnitude of the problem, because their training is costly, and professionals are accustomed to working in high technology oriented settings, so that they seldom function well outside the city or large towns.
Canadian Manpower Model
| Cadre | Level | Period of Training | Percentage of tasks managed |
| Professional | Level I | More than 2 years | 20% |
| Professional | Level II | More than 2 years | 20% |
| Non-professional | Level III | Less than 2 Years | 80% |
| Non-professional | Level IV | Less than 2 Years | 80% |
- Trained professionals are not adequately available
- Non-professionals can complete 80% of the tasks in a CBR programme
- Cost of using non-professionals is low
Types of tasks in CBR
1. Technical Tasks
Disability assessment, therapeutic interventions, family counselling, counselling for rehabilitation
2. Programme Management
Community organisation, community development, public education, programme supervision, advocacy, income generation for the family, organisation of self help groups, record keeping.
| Model I | Role | Model II | Role |
| CBR Manager | Administrator | CBR Manager | Administrator |
| Professional | Trainer/ Professional | Professional | Trainer/ Professional |
| Mid Level Rehabilitation worker (MLRW) | Multipurpose worker / Trainer / supervisor of CBRW | 1. Therapy Assistant 2. CBR Supervisor |
1.Technical/Trainer of CRW 2. Programme Management/Trainer of CRW |
| CBR Worker | Multipurpose/ Low depth/ interacts with family | CBR Worker | Multipurpose/ Low depth/ interacts with family |
| LEVELS | CURRICULUM FOR | ESSENTIAL | DESIRABLE | UNDESI-RABLE |
| I - CBR Manager | Manager's training | ** | ** | ** |
| II - Professional | Professional's training | ** | ** | ** |
| III - Mid-level Rehab worker(CBR Supervisor & Therapy asst.) | MLRW's &CBR supervisor'straining. Therapy assistant's training | ** | ** | ** |
| IV - CBR worker | CBR worker's training | 1.Home based interventions 2.Community & family organisation 3.Teaching skills |
1. Prevention 2. Awareness programmes 3.Govt. schemes |
1.institutio-n based interventio-ns |
| Family of the Disabled Person | Family member's training for home based intervention | ** | ** | ** |
Curriculum development is about ` what to teach and how to teach'. It is procedural in nature. Students' needs are analysed and learning goals and objectives are identified. The syllabus is a document which says what is required to be learnt. Syllabus design takes care of selecting, grading and sequencing the content of the course.
The components of the curriculum are those activities that will train the groups of trainees to acquire essential knowledge to carry out the desired work at a pre-designed level of functioning. Usually qualifying tests estimate if the individual trainee has achieved the essential level of knowledge. The desirable components are those that improve the trainees' ability to carry out the work better than the minimum necessary level of functioning. The qualifying tests estimate these components to grade the achievement of the trainee beyond the minimum necessity. Undesirable components if learned can have a detrimental effect on the functioning of the trainee in his work situation. The qualifying tests give negative points to these components of learning. Some developmental organisations in India have noticed that high turnover of staff in the community occur as a result of over training them for the job. It will be helpful to do a task analysis of the trainees, because a task analysis will give a precise idea of the tasks expected to be completed by a group of trainees in their normal working state. The desired level of suitability is a level at which the effectiveness of the intervention is the maximum at an affordable cost. Sometimes the desired level is considered to be the level at which the effectiveness tends to plateau out with increasing costs.
Most CBR workers' courses have derived out of regular institutional courses. The curriculum in most instances is prepared based on the experience of the institutional instructors, who teach trainees to work in an institutional set up. They are loaded with technical skills training and lack the essential prerequisites to be successful in the community, namely, the ability to be innovative and to organise the families and the community for CBR work. This results in the CBR workers functioning as institutional extension workers, rather than as community workers. This disparity in their mode of work in relation to their proposed role in CBR, leads to conflict with their donors who want them to initiate community participation in CBR, and with the professional course designers who seldom want this transfer of responsibilities taking place or are ignorant of its significance. It is proposed that the CBR workers' courses should have an independent, stand-alone curriculum, rather than a modification of the institutional courses that are prevalent now.
Dr. Maya Thomas & Dr. M J Thomas
J-124, Ushas Apts, 16th Main, 4th Block, Jayanagar, Bangalore - 560 011, India
Tel and fax : 91-80-6633762
Email : thomasmaya@hotmail.com
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