Determining the vocational competencies required to deliver community-based rehabilitation and inclusive development services in India

Abstract

Purpose

To identify the competencies required by Community-Based Rehabilitation (CBR) practitioners in India and determine typical pathways of competency development, including minimum practice standards.

Methods

Following a literature review of existing frameworks and guidelines for CBR delivery, Delphi methods were used with Indian CBR experts to identify the main competency requirements of CBR personnel. Rubric writing workshops with CBR experts then expressed the performance of these competencies developmentally as learning progressions. The rubrics were converted into an observation form and field tested with 100 CBR personnel of varying expertise levels, through third party assessments by workplace supervisors. Finally, a second Delphi panel determined major competency stages and minimum standards for practice.

Results

Three broad job functions pertaining to five focus areas and 37 developmentally described competencies were found important for delivery of quality CBR. Through a standard setting process, for each job function experts reached agreement on major competency stages, including a minimum practice standard.

Conclusions

The study suggests India’s CBR expertise proceeds in four stages within three broad job functions – Assessment and Intervention, Inclusive Community Development, and Professional and Ethical Behaviour and Practice. The findings have direct implications for designing curricula to facilitate the competency development of CBR personnel.

Implications for rehabilitation

• Meeting the rehabilitation and inclusion needs of people with disability in low and middle-income countries requires adequately trained local personnel.

• Currently, lack of knowledge and understanding of the competencies required of CBR personnel is affecting training and workforce quality.

• Consensus amongst Indian experts about a CBR learning pathway indicates possibilities for effective competency-based course design.

Keywords:

• Community-based rehabilitation
• competencies
• learning progressions
• disability inclusion
• community development

Acknowledgements

We acknowledge the central role and leadership of the Rehabilitation Council of India (RCI) and the Department of Empowerment of People with Disability (Ministry of Social Justice and Empowerment, Government of India) in enabling the development of the competency framework and facilitating its application into a training program under RCI. We also acknowledge the following subject-matter experts who contributed to the development of the hypothesized competency framework and supported data collection:

Pankaj Maru, Founder and President, Special Needs Education Home, India

Carmo Noronha, Executive Director, Bethany Society, Shillong India

Bhushan Punani, Executive Secretary, Blind People’s Association, India

Jubin Varghese, Disability Project Manager, Emmanuel Hospitals Association, India

Sara Varughese, Country Director and Managing Trustee, CBM India.

Disclosure statement

The authors report no conflict of interest and no external funding for this study. It was funded internally, by the Melbourne Disability Institute, University of Melbourne.