A Review of the Community Integrated Rehabilitation of the Blind Project In Krachi District

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The WHO estimates that there are about 180 million people worldwide with visual disability, out of which approximately 40-45 million are totally blind. About 75% of the world’s blind live in developing countries. The prevalence of blindness is highest in the poorer rural areas where eye care services are non-existent. In developing countries, especially in Africa, blindness is attributed to a curse or punishment for wrongdoing. Even within the traditional extended family system, the blind are seen as a burden due to their inability to contribute to the family income. Rehabilitation therefore aims at making the blind self-reliant through the acquisition of orientation and mobility, daily living and vocational skills and to enhance their social integration into their respective communities. In Ghana, examples of rehabilitation of the blind projects are: Binaba Agricultural Rehabilitation for the Blind (BARB) in the Upper East region and the Community Integrated Rehabilitation of the Blind (CIRB) projects in the Hohoe and Krachi Districts of the Volta Region. The Krachi CIRB project was established in January 1998 to provide comprehensive rehabilitation services to blind and visually impaired persons in the district. It has so far rehabilitated 276 clients. Since the inception of the project no external assessment has been done to guide management on its implementation. The main focus of this study therefore is to assess the effectiveness of the project and its potential benefits to the beneficiaries. The study is based on the following variables: Effectiveness Management Participation Community Participation Multi - sectoral Collaboration Socio-cultural factors. The rationale of the study is to determine if the project can improve upon capacity building, poverty reduction and social integration of the blind. The study is a descriptive cross-sectional one. Simple random sampling of five unit rehabilitation committees (URC) out of twelve was done to select the units for the study. In each unit, the first fifteen members on the clients register were purposively selected and interviewed. In addition, two volunteers, two URC members (chairman and one other member) were interviewed using semi-structured questionnaire. Focus Groups Discussions (FGD) were held in the units and members of the DRC and 6 key informants were interviewed. Secondary data was reviewed from project documents and records. The results of the study indicate that the project has established a service delivery process for the rehabilitation of blind and visually impaired persons. During the period under review, the project rehabilitated 276 clients and provided credit to 63.6% of them. The findings indicate that 50% clients were likely to enjoy major benefits from the rehabilitation programme, 28% moderate benefit and 22% little benefit. Management was assessed to be satisfactory and community Participation was low in three units and high in two units. The main problem associated with community participation were Poor quality of leadership Lack of community mobilization of resources Dormant community structures. The Level of Multi - sectoral collaboration or networking in service delivery was found to be high. The existing socio-cultural factors in the communities didn’t greatly enhance the outcome of rehabilitation. In conclusion the project has so far been able to achieve its aims and objectives. On the other hand the rationale for providing vocational training to all clients irrespective of age and physical condition should be re-visited. The project has been able to improve upon capacity building and poverty reduction in the blind. However the process of social integration is slow.
A Thesis Submitted to the School of Postgraduate Studies, Kwame Nkrumah University of Science and Technology, Kurnasi, Ghana in partial fulfillment of the requirements for the award of the degree of Master of Science in Health Services Planning and Management, 2002