BARRIERS AND FACILITATORS TO COMMUNITY-BASED REHABILITATION SERVICES FOR DISABLED INDIVIDUALS: A QUALITATIVE ANALYSIS

Abstract

Background: Community-based rehabilitation (CBR) is a globally endorsed strategy to enhance the quality of life and social inclusion of individuals with disabilities. Despite its potential, barriers to equitable access and implementation persist, particularly in under-resourced settings.

Objective: To explore the key barriers and facilitators influencing access to and engagement with community-based rehabilitation services among disabled individuals.

Methods: A mixed-methods study was conducted over eight months across five rehabilitation centers. Thirty-five participants with various disabilities were recruited through purposive sampling. Data collection involved semi-structured interviews, the Community Integration Questionnaire (CIQ), and the WHO Disability Assessment Schedule 2.0 (WHODAS 2.0). Quantitative data were analyzed using parametric tests, while thematic analysis was employed for qualitative insights. Correlation analysis was used to explore associations between disability-related challenges and community integration.

Results: Home integration scored highest on the CIQ (mean = 7.8, SD = 2.1), while productive activities scored lowest (mean = 3.9, SD = 1.6). WHODAS results indicated high impairment in participation (mean = 40.2, SD = 6.9) and life activities (mean = 35.9, SD = 7.2). Negative correlations were observed between WHODAS scores and CIQ outcomes (p < 0.05). Commonly reported barriers included inaccessible transport (83%) and lack of assistive devices (71%), whereas facilitators involved family support (74%) and continuity of care (63%).

Conclusion: Barriers to community-based rehabilitation remain significant, but targeted facilitators offer practical avenues for enhancing access and participation. Strengthening policy frameworks, transport accessibility, and community-oriented interventions can substantially improve rehabilitation outcomes.