The CBR in Palestine started out with several pilot rehabilitation programmes beginning in 1990. Gaza was the pioneer starting in 1990, followed by Jenin in 1992 and the Central Region in 1993. The CBR Programme in the South Region and in Nablus was established in 1995. The Regional Committees, comprising representatives of partner NGOs, are in charge of development of CBR in the respective Regions, while technical and financial support to the CBR Programme is provided by the NAD/Diakonia Field Office in Jerusalem.

SINTEF Health Research visited Palestine in December 2000 in order to consider the viability of conducting an impact assessment of the Community Based Rehabilitation Programme (CBR) in Palestine. Included in the consideration were both methodological issues and problems related to conducting such a study in a conflict area. Following this visit, an agreement was made between The Norwegian Association of the Disabled (NAD) and SINTEF in January 2001. Preparations for the study, data collections, analyses and report writing have been carried out in the period from February to June 2001. During this period, SINTEF visited Palestine three times, spending a total of four weeks working together with  staff at the Diakonia office in Jerusalem, Project Managers, Supervisors and Community Based Rehabilitation Workers (CRWs) in the CBR Programme on the West Bank and in Gaza.     

Aims and objectives
The aim of the Impact Assessment has been to measure the results of the Community Based Rehabilitation Programme in Palestine on the different relevant levels:
• Individual persons with disabilities who have received the services of the CBR
• Families of individuals with disabilities who have received services from the CBR
• Participating local communities
The assessment has been carried out by multiple methods and include a quantitative Baseline follow-up study, a Record Audit, Focus Groups, and interviews with families with disabled members, service providers, organisations of people with disabilities, and Project Managers in the CBR All information gathered and analysed indicate clearly that the CBR Programme has had substantial impact on individuals with disabilities, their families, and their local communities.  

Recommendations
• It is timely after more than ten years of implementation to critically examine different strategies for future development of the CBR Programme.
• The Regional differences should be addressed, primarily in order to reduce possible variation in quality and efficiency between Regions.
• In order to reduce unwanted Regional differences, one should consider both training of CRWs and other efforts to streamline activities to the extent that this is not in conflict with the decentralised model.
• The case file system should be revised in order to measure a broader range of impact, including awareness, attitudes, psychosocial and social-integrative aspects, to increase both specificity and sensitivity, and to improve it as a tool for evaluations and research.
• Standardisation of the record keeping should in general be considered.

Contact: Arne H. Eide, SINTEF Health Research

Read more about NAD's CBR-program in Palestina. (in Norwegian)