The evolution of community-based rehabilitation (CBR) programmes: a call for mixed evaluation methodologies

Abstract

Purpose – For the past four decades, there is no evidence of a consensus on the suitable community-based rehabilitation (CBR) evaluation methodologies. To this end, the purpose of this study is to provide a narrative review on CBR evaluations and the potential of photovoice method when used alone and when used in combination with quality of life assessment tools as CBR evaluation methodologies. Design/methodology/approach – A narrative review was undertaken, but including some aspects of scoping review methodology. Findings – Thirty-three full-text articles were included for review. Three key findings were an overview of the evolution of CBR evaluation; the use of photovoice method in CBR evaluation and the use of photovoice method in combination with quality of life assessment tools in CBR evaluation. Research limitations/implications – Photovoice methodology was found to be participatory in nature and as has the potential to elicit the experiences of persons with disabilities. However, photovoice falls short of measuring the quality of life of persons with disabilities, thus will need to be collaborated with another assessment tool. A combination of photovoice and World Health Organization Quality of Life (WHOQOL)-BREF and WHOQOL-Dis assessment has a potential to give an adequate representation of the voices of persons with disabilities and their quality of life. Originality/value – There is need for changes in CBR evaluation methodologies in response to the evolution of disability models from medical model to human rights model. Thus CBR evaluation methodologies should embrace the diversity among persons with disabilities in interpreting life experiences and quality of life.

Keywords

• community-based rehabilitation
• photovoice method
• whoqol-bref