02515nas a2200265   4500000000100000008004100001260001300042653003300055653003000088653002100118653002100139653001100160653001200171653002200183653001500205100002300220700001100243245012300254856005100377300001000428490000700438050003200445520175800477022001402235       2008                            d  c2008 Mar10aAttitude of Health Personnel10aCommunity Health Services10aDisabled Persons10aHealth Personnel10aHumans10aleprosy10aProfessional Role10aVolunteers1 aFinkenflügel HJ M1 aRule S00aIntegrating community-based rehabilitation and leprosy rehabilitation services into an inclusive development approach.  uhttps://leprosyreview.org/article/79/1/08-3091  a83-910 v79  aInfolep Library - available3 a<p>Community-based rehabilitation (CBR) has been described as a strategy for leprosy rehabilitation. Developments in CBR and leprosy rehabilitation services, including Socio-economic rehabilitation (SER) show that both approaches aim to become part of a community development process. The basic assumption is that people with disabilities will benefit most from being included in mainstream programmes implemented in their own community, e.g. programmes aiming to improve livelihood. These developments have a decisive impact on the roles of all people involved in the rehabilitation process. Where the emphasis in the rehabilitation process shifts to the community and becomes part of community development, the rehabilitation workers need different competencies than were required in vertical disability programmes. This article focuses on the changing roles of mid-level rehabilitation workers and trainers and therapists. In many programmes a mid-level cadre was introduced to work with people with disabilities and their families. Consequently, trainers and therapists have moved away from direct, hands-on interventions and focussed on training this mid-level cadre and offering specialised referral services. This system was primarily developed to provide treatment at all levels, including community level. However, when rehabilitation becomes part of a community development process there is a need for 'change agents' and a structure that supports them. The success of integrating disability specific programmes like CBR and SER, into inclusive development programmes will depend largely on the extent to which rehabilitation workers are able to reinvent themselves as 'change agents' and redefine their roles, positions, and competencies.</p>  a0305-7518