Article

Community-based rehabilitation (CBR) must prove that it is making a
significant difference for people with disabilities in low- and middle-income
countries. Yet, evaluation is not a common practice and the evidence for its
effectiveness is fragmented and largely insufficient. The objective of this
article was to review the literature on best practices in program evaluation in
CBR in relation to the evaluative process, the frameworks, and the methods of
data collection. METHOD: A systematic search was conducted on five rehabilitation
databases and the World Health Organization website with keywords associated with
CBR and program evaluation. Two independent researchers selected the articles.
RESULTS: Twenty-two documents were included. The results suggest that (1) the
evaluative process needs to be conducted in close collaboration with the local
community, including people with disabilities, and to be followed by sharing the
findings and taking actions, (2) many frameworks have been proposed to evaluate
CBR but no agreement has been reached, and (3) qualitative methodologies have
dominated the scene in CBR so far, but their combination with quantitative
methods has a lot of potential to better capture the effectiveness of this
strategy. CONCLUSIONS: In order to facilitate and improve evaluations in CBR,
there is an urgent need to agree on a common framework, such as the CBR matrix,
and to develop best practice guidelines based on the literature available and
consensus among a group of experts. These will need to demonstrate a good balance
between community development and standards for effective evaluations.
Implications for Rehabilitation In the quest for evidence of the effectiveness of
community-based rehabilitation (CBR), a shared program evaluation framework would
better enable the combination of findings from different studies. The evaluation
of CBR programs should always include sharing findings and taking action for the
sake of the local community. Although qualitative methodologies have dominated
the scene in CBR and remain highly relevant, there is also a call for the
inclusion of quantitative indicators in order to capture the progress made by
people participating in CBR programs. The production of best practice guidelines
for evaluation in CBR could foster accountable and empowering program evaluations
that are congruent with the principles at the heart of CBR and the standards for
effective evaluations.

Langue : ANGLAIS