Appreciation of community-based rehabilitation by caregivers of children with a disability.

Evaluations of community-based rehabilitation (CBR) programmes generally focus on quantitative data. To gain insight into the determinants of the outcomes, process-oriented data are needed. From the literature six variables have been identified that possibly correlate with the evaluation of CBR by caregivers of children with a disability. These variables are: (1) traditional beliefs, (2) impact of a child with a disability on the caregiver, (3) community involvement, (4) perceived ability to teach the child, (5) attitude towards various health services, and (6) expectations for the future of a disabled child. The study was done in the CBR projects in Zimbabwe. Seventy-five caregivers were interviewed. Background, perceived abilities to teach and expectations of the caregivers were very different. This study revealed a significant correlation between the appreciation of CBR and the attitude towards various health services, and between the perceived ability to teach and the expectations for the future of the child.

Formal handling routines: child rearing practices in Jamaica

The objective of this study was to describe the use of the formal handling routine in young children with and without a disability in a rural community in Jamaica. In all, 52 care-givers were interviewed and videotapes of some care-givers carrying out their routine were made and analyzed. Results showed that Jamaican care-givers are carrying out these routines because of tradition and to influence the child's growth. The formal handling routine included "sopping", "stretching", "active exercises", "shaping", "massage" and "catching-up" and are carried out once or twice a day from birth until the child is able to move around by itself. Care-givers of a child with a disability started at a later age with the routine and continued it longer. On noticing that their child's reaction during the routine was different in comparison to other children they adjusted the way of carrying out the routine according to the child's reaction and also carried it out more frequently. Jamaican care-givers seem to be experienced in exercising their children, and spend much time on it and have a lot of knowledge about influencing their child's development. This knowledge and experience can be utilized by community rehabilitation workers in exercising children with a disability (AU)

Identifying people in need of rehabilitation in rural Zimbabwe.

The Ministry of Health of Zimbabwe has initiated eight Community-based Rehabilitation projects in rural areas. Within each project, a survey was undertaken to identify people with a disability who could benefit from these projects. This article discusses the set-up, outcome and shortcomings of the surveys. The results of the surveys are compared with previous studies on people in need of rehabilitation in Zimbabwe. The surveys led to three major findings: 1. The majority of the people in need of rehabilitation in the rural areas have not been in contact with rehabilitation services before; 2. The results of the surveys differ from previous studies in terms of the numbers of clients in the different diagnostic categories; 3. Community-based rehabilitation deals with a different group of clients compared with hospital-based Rehabilitation. The use of the ICIDH is recommended to standardise future surveys. Implications for the development of rehabilitation services are discussed in the article.

Help for the disabled--in hospital and at home.

In Zimbabwe, rehabilitation technicians were initially trained to provide a basic service for disabled people in provincial and district hospitals. The setting up of community-based rehabilitation programmes has meant that some of these workers have had to become more family- and community-oriented.