EDITOR'S COMMENT
The UN Convention on Rights of Persons with Disabilities (2006) emphasises "the equal right of all persons with disabilities to live in the community, with choices equal to others" (Article 19). Further, Article 26 recommends that "Support, participation and inclusion in the community and all aspects of society, are voluntary, and are available to persons with disabilities as close as possible to their own communities, including in rural areas." These articles are relevant to community-based rehabilitation (CBR), arguably the most significant innovation for people with disabilities, especially for those in rural areas in developing countries. CBR today is understood by most stakeholders in the disability sector as a strategy to promote inclusion, rights and equal opportunities for people with disabilities.
Although many evaluation reports have documented the positive benefits of CBR, there is little in published domain about its effectiveness, and the field is criticised as having poorly defined indicators to measure success. All CBR stakeholders should be able to demonstrate the benefit of their programmes, in order to influence policy makers and donors to continue to support them. Over the past decade, researchers from different parts of the world have suggested tools and methods for evaluation of CBR, and some have developed sets of indicators too.
Many CBR programmes have been in existence for a decade or more, but a majority does not have clear baseline data, apart from demographic data on numbers of persons with disabilities in their programme and the activities that are carried out. Baseline data against which to measure progress, for example, levels and limits of participation or inclusion, are usually absent. Most programmes have well developed logframes, but rarely use them in monitoring and evaluation because data are not collected or analysed according to the logframe. While objectives and activities may be clearly defined, results and outcomes are not. As a result, it is difficult for most evaluators to draw clear inferences about effectiveness of the programme from their findings.
Training on evaluation for CBR planners and implementers needs to focus on the importance of baseline data from the perspective of monitoring and evaluation, and of defining outcomes/results. Once the outcomes/results are defined, it becomes easier to develop the appropriate quantitative and qualitative indicators to measure success achieved in relation to that outcome. For example, in the domain of education, the expected results may be that education institutions become 'inclusive'; that children with disabilities are able to attend inclusive or special education; that adults or older children with disabilities acquire functional literacy. Indicators in relation to these outcomes could be the number of educational institutions in the area that accept children with disabilities and have made the learning environment accessible; number or percentage of children with disabilities from the programme completing different levels or forms of education. Baseline data about the number of children with disabilities in different age groups who were eligible to be enrolled into the education system at the beginning of the programme, would be the basis for calculating the percentage of children who reached the desired result. This way, the success of the programme in the domain of education can be clearly measured.
Likewise, outcomes/results for different domains of CBR programmes, such as inclusion and participation in family and community life, livelihoods, health and rehabilitation, advocacy and awareness raising, etc. need to be defined by the programme at the stage of planning, along with the relevant indicators and the baseline data needed for each domain. The WHO CBR matrix can be a useful tool to define the different CBR domains. While it may not be possible to have a universal set of indicators to measure success in CBR, it is certainly feasible and necessary for each programme to define its desired outcomes/results and indicators, and to evaluate their success and achievements accordingly.
The APDRJ team wishes all readers a happy new year!
Dr. Maya Thomas
Editor