Community-based rehabilitation and health professional practice: developmental opportunities and challenges in the global North and South

Abstract

Purpose. This article examines the politically-charged and hotly contested issue of the role of professionals can and should play in the provision of disability services in both the global North and South, with specific reference to Community-Based Rehabilitation (CBR).

Method. A discursive theoretical discussion of the issues regarding the current and normative power relations that exist between disabled people and professionals working in the health sector is undertaken, by drawing upon contemporary debates in disability studies, rehabilitation, development studies and political science. This article provides an historical analysis of the development and subsequent critique of the underlying principles of CBR. Reference is then to the social model of disability and how it relates to client–professional relationships and subsequently analyses what impact and implications this has for professional practice.

Results. The normative relationships that exist between disabled people and health professionals remains a contested area. Political imperatives for increased user involvement and public sector reform necessitate the reconfiguration of client–professional relationships. However, there is scant agreement on precisely how this should take place.

Conclusion. The article concludes by suggesting practical strategies on how health and care services can be provided in a manner that embraces the positive characteristics of the social model of disability, and which enables professionals, such as occupational therapists, rehabilitation professionals and physicians to act as facilitators in extending the human rights and responsibilities of disabled people.

Keywords:

• Community-based rehabilitation
• participation
• professional practice

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.