A study conducted in 2008 explored some of the implications of a NGO-initiated Community Based Rehabilitation (CBR) programme in a low income, peri-urban context in KwaZulu-Natal, South Africa. The CBR programme is one aspect of comprehensive primary health care provided by the NGO, The Valley Trust. This study had two primary aims; to examine the costs of implementing the CBR programme and to explore the benefits and challenges associated with the programme.

"The Valley Trust's CBR programme is effective in providing rehabilitation services to people with disabilities who would not otherwise have reliable access to any form of rehabilitation. Previous evaluations of CBR programmes using multi-skilled mid-level workers in South Africa have shown that they have significant benefits for people with disabilities in rural areas. This study reinforces these findings," said Suraya Dawad, the lead researcher of the project. She added that the benefits of the programme also fit fairly closely with WHO’s priorities for CBR, including physical rehabilitation and social integration.

The uncertainty around the future of the CBR programme is however a cause for concern. "This uncertainty is influenced by several interacting factors, including the changing policy framework around mid-level rehabilitation workers, the difficulty in securing funding, the changing priorities of The Valley Trust itself and the lack of government support," added Dawad.

She said how these interacting factors are resolved will directly impact on the quality of life of people with disabilities in the area and, given the effectiveness of the CBR programme. "The recommendation is that every effort should be made to ensure that it continues to operate," concluded Dawad.

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