Community-based Rehabilitation for People With Disabilities in Low- and Middle-income Countries: A Systematic Review

Recent estimates suggest that there are over one billion people with disabilities in the world and 80% of them live in low- and middle-income countries. Community-based rehabilitation (CBR) is the strategy endorsed by the WHO and other international organisations (ILO, IDDC and others) to promote the inclusion of people with disabilities, particularly in low- and middle-income countries. The coverage of CBR is currently very low, and the evidence-base for its effectiveness needs to be assessed in consideration of scaling up of this intervention. This systematic review and meta-analysis aimed to assess the effectiveness and cost-effectiveness of CBR for people with physical and mental disabilities in low- and middle-income countries, and/or their family, their carers, and their community.

15 studies were included out of which six focused on physical disabilities (stroke, arthritis, chronic obstructive pulmonary disease) and nine on mental disabilities (schizophrenia, dementia, intellectual impairment). The evidence on the effectiveness of CBR for people with disabilities in low- and middle-income countries suggests that CBR may be effective in improving the clinical outcomes and enhancing functioning and quality of life of the person with disabilities and his/her carer. However the heterogeneity of the interventions and scarcity of good-quality evidence means that we should interpret these findings with caution. 

Citation: Iemmi V, Gibson L, Blanchet K, Suresh Kumar K, Rath S, Hartley S, Murthy GVS, Patel V, Weber J, Kuper H. Community-based Rehabilitation for People With Disabilities in Low- and Middle-income Countries: A Systematic Review Campbell Systematic Reviews 2015:15 

Image courtesy of Valentina Iemmi. Copyright © 2015 Valentina Iemmi. All rights reserved