CHAPTER : NATIONAL DISTRICT LEVEL REHABILITATION

PROGRAMME
Framework for Service Delivery:
When setting up a framework for service delivery, it is proposed to follow the
recommendations and directives made by the Rehabilitation Council of India. The
Council Act of 1992 requires that organizations that deliver services for persons
with disabilities will employ only personnel that meet the requirements for
competence. For a CBR programme, the Council has decided that it is appropriate
to use a “Multi-purpose Rehabilitation Worker (MRW)”. At the community
(Gram Panchayat) level, a community worker (Local Facilitator - LF) should be
chosen by the community and trained.
The principles of the service delivery system as shown above may be described
as follows:

At the Gram Panchayat level, the local Panchayat committee or a special

rehabilitation committee will micro-manage the CBR programme. It decides if and
when the community will start a CBR programme, what resources to provide
(such as employing and training a community facilitator), and assists in providing
access to schemes for functional training, inclusive education, rural development,
health, social welfare benefits, care and economic support.

 At the Taluk level, the MRW will be responsible for the information to
community leaders and to persons with disabilities and their families about
disability and what the community can do to provide services and
opportunities using already available resources. The MRW will co-operate
with personnel at PHC, education, labour, social welfare NGOs and others,
which will make services available and open opportunities for persons with
disabilities.
 At the District level, a district technical rehabilitation coordinator will
monitor and guide the work carried out at more peripheral levels. Liaisons
will be established with specialists at referral levels in a two-way system.
Not only will disabled persons living in the community get access to
specialized care; also disabled persons in centers will be referred back to
their homes and continue the rehabilitation process there. A report system
will be set up to serve the State Administration.
  At the State level, a cell will be created within the nodal department, the
Department of Disabled Welfare. This CBR coordination cell will be
involved in macro-management, planning, monitoring, evaluation, guiding
technical development and overseeing training programs for MRWs, LFs
and other categories of personnel involved in the programme. It should be
remarked that there is also another option for a service delivery system,
namely to add the responsibilities to an already existing category of
personnel. The experience of this option is rather negative for four reasons:
The personnel chosen from one sector will most often neglect or even be ignorant of
how other sectors engage to meet the needs of disabled people, The training costs
are substantially higher, as often 8-10 times more personnel will have to be trained,
There is most often a lack of clear responsibility for the whole rehabilitation
programme, which is avoided when MRWs are employed, and
The personnel will most often lack sufficient experience.
Duties and Responsibilities of Implementing Agency Personnel:

A) The Local Facilitator (LF) is a community worker who:

1. May work on full time or part-time basis,
2. Is chosen by the community and under the management of its leaders,
3. Is trained and subsequently supervised by the MRW
4. Undertakes tasks related to the identification of disabled people, followed
by locating, motivating and preparing a trainer for each of them,
5. undertakes the transfer of rehabilitation technology to the family and
community members,
6. Assists in the functional training and in the production of simple
rehabilitation appliances,
7. Contacts other community members or local authorities to arrange for disabled
people’s participation in all locally available development programs, such as
those related to poverty alleviation, pre-school activities, schooling and other special
education, vocational training and other job-oriented programmes, legal protection,
home care, etc.,
8. Contacts welfare or other activities which provide benefits or grants for disabled
people;
9. Initiates social contacts and participation in all aspects of community life, with
the aim of fully integrating disabled people, and
10. Keeps records and monitors and reports progress of the programs to all those
concerned.
B) The Multipurpose Rehabilitation Worker (MRW)

The MRW will work at the Taluk level:

1. Initiating contacts with communities and providing the information

requested on the CBR Programme,
2. Visiting communities to advise them on the practical aspects of the
CBR Programme,
3. Designing, conducting and evaluating courses to train local
facilitators (LFs),
4. Assisting in the development of multi-sectoral contact, so disabled
people will be involved in mainstream rural development schemes,
receive primary health care, education, and ability training, and be
given opportunities for gainful employment,
5. Contacting referral services, public authorities, or private
organizations, regarding disabled people in need of diagnostic,
therapeutic or rehabilitation services and/or opportunities for
assessment, guidance, counseling, schooling, and ability training
such as vocational training,
6. Monitoring all aspects of the legal protection of disabled people to
ensure observance of their human rights and adequate representation
of the disabled people and their families in all community affairs
that are of special interest to them.
7. Ensuring appropriate monitoring of the CBR Programs of all
communities in the district and taking steps to correct problems that
become apparent on monitoring; reporting monitored information
and data to higher levels, and responding to directives aimed at
reprogramming or at other changes, and
8. Assisting, in co-operation with the local and district administrations,
with the necessary administrative action to ensure smooth
functioning of the programme.
c) The District CBR Coordinator

The coordinator:

1. Plans for, monitors and guides all CBR programmes, including the
training of LFs, in the district,
2. Provides technical support and liaison with referral levels for the
rehabilitation activities that cannot be carried out at community or
taluk levels,
3. Reports on the district activities to the district authorities and
committees and to the state level, and
4. Provides orientation and awareness courses for all personnel at
district level who are involved in CBR Programs.
d) The State CBR Coordinator

The state coordinator:

1. Undertakes all planning for resource requirements and provisions for

the entire state, including the budgeting process,
2. Monitors and evaluates all reports, intervenes to correct managerial
problems, and reports to the appropriate authorities on the outcomes
of the programme,
3. Supervises all training of personnel engaged in CBR, and
4. Liaisons with the State Commissioner and the Coordination
Executive Committees and other bodies as required.
Duties and Responsibilities of the Committees:

State level Committees:

The duties and responsibilities of the State Coordination and Executive

Committees are defined in the 1995 Act. These committees, in addition to those
mentioned in the Act, should also make room for representation of the disabled
people, families with disabled people, NGOs implementing CBR and other
departments concerning poverty alleviation, education and other development
activities.

Inter-Departmental Coordination:
The active collaboration of the following departments is a prerequisite for an
optimal functioning of the CBR Programme:
Department of Education,
Department of Women and Child Welfare,
Department of Health,
Department of Rural Development,
Department of Social Welfare, and
Department of Labour.

Duties and Responsibilities of Nodal Agency:

The Department for Welfare of Disabled is:

1. To select a nodal training agency and arrange for MRW training,

2. To recruit and employ,
3. To select districts with the target of covering 80% of disabled people of all
districts in ten years time,
4. To ensure economic support to Panchayats from the existing development
programmes and schemes for disabled people,
5. To establish linkages between Panchayats at district, Taluk and village levels
with concerned government departments at all levels,
6. To set up District CBR Coordinating committees at Jilla Panchayat office,
7. To ensure that Taluk CBR Coordination committees are set up at the Taluk
Panchayat office, and
8. To ensure that village level CBR coordinating committees are set up at the gram
Panchayat office.
Duties and Responsibilities of Nodal Training agency:
1. To set up a training centre for MRW training,
2. To implement the MRW training curriculum approved by the Rehabilitation
Council of India,
3. To arrange accommodation for 60 MRW’s per year,
4. To train 540 MRW’s in 10 years,
5. To set up a CBR Training coordination committee with a Director for Disabled
Welfare, Disabled persons, NGOs, experts on CBR, and representatives from
Education, Health, Welfare, Rural Development, Labour and other concerned
departments, and
6. To report to the State CBR Coordination Committee once a year.
Decentralized Levels:

Duties and Responsibilities of District CBR Committee:

1. To set up Taluk CBR Coordination Committees comprised of

disabled persons, NGOs, families with disabled persons, and
representatives from health, education, welfare, rural development
and other concerned departments, with Taluk Panchayat president as
the Chairperson of the committee. The person responsible for the
execution of its decision is the District CBR Coordinator,
2. To ensure the establishment of appropriate monitoring systems,
3. To ensure that the resources for rehabilitation services are available
in time for village Panchayat,
4. To motivate village Panchayats to take up CBR programme,
5. To establish necessary linkages with various departments to assist
the village Panchayats to avail the benefits from the existing
schemes, and
6. To report to the state CBR coordinator every month.

Duties and Responsibilities of Taluk CBR committees:

1. To ensure that village level CBR coordination is established,

2. To assist the village Panchayat to mobilize resources,
3. To establish linkages with various departments in order to assist the village
Panchayat to avail the benefit from the existing scheme for people with disabilities,
4. To assist, guide, and monitor the function of MRWs, and
5. To report to Jilla Panchayat once in a month.
Duties and Responsibilities of the Village Panchayat:
1. To select and arrange for training and appoint a Local Facilitator,
2. To pay honorarium for the local facilitator,
3. To monitor the CBR programme,
4. To arrange for rehabilitation services by using existing schemes for disabled,
rural development schemes, and education schemes, and by mobilising local
resources,
5. To ensure full participation of people with disabilities and their families in CBR
programme, and
6. To ensure the evaluation of the CBR program at the end of the 3rd year and
revise the scheme based on the evaluation results. Managerial Structure
Framework for CBR Programme
Proposed Managerial Structure and Linkages for CBR

STRUCTURE LINKAGES

Director for the Welfare of Disabled

persons

State CBR State CBR Coordination

Coordinator Committee

District CBR District CBR

Coordinator Coordination
Committee

Taluk Multipurpose
Rehabilitation Taluk CBR Coordination
Committee
Workers

Village Local Facilitator

Village CBR Coordination
committee
Note: At each district there will be one MRW working at the Taluk level for one lakh
people. At each village Panchayat there will be one LF for about 5000 people.