ArticleConflict and health2021
The impact of a community based rehabilitation program in Afghanistan: a longitudinal analysis using propensity score matching and difference in difference analysis.
Article in Conflict and health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 9 citations in OpenAlex.
- Low-cost Rehabilitation Solutions: Lessons From LMIC Settings.Current neurology and neuroscience reports · 2026Review
- Advancing inclusive development through community-based rehabilitation: a systematic literature review.Frontiers in rehabilitation sciences · 2026Review
- "I became a person again": Social inclusion and participation experiences of Ethiopian women post-obstetric fistula surgical repair.PloS one · 2024Article
- Access to Services from Persons with Disabilities in Afghanistan: Is Community Based Rehabilitation Making a Difference?International journal of environmental research and public health · 2022Article
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe 2006 United Nations Convention on the Rights of Persons with Disabilities states that the achievement of equal rights, empowerment and social inclusion of people with disabilities requires comprehensive rehabilitation services encompassing all components of the World Health Organization Community based rehabilitation (CBR) matrix: health, education, livelihood, social and empowerment. CBR programs specifically aim to deliver such comprehensive interventions. In the present study, we investigate the impact of a CBR program in Afghanistan on all these components.
methodsWe enrolled 1861 newly recruited CBR participants with disabilities in the study, from 169 villages between July 2012 and December 2013 as well as 1132 controls with disabilities randomly selected through a two-stage process within 6000 households from 100 villages in the same provinces but outside the catchment area of the CBR program. We interviewed them again after one (midline) and two (end-line) years in the study. Using propensity score matching and difference in difference analysis, we estimated the impact of the CBR on outcomes of interest, namely mobility, activities of daily living, communication, participation in social and community life, emotional well-being and employment.
resultsThree years on average into the CBR program, participants showed a significant and close to medium effect size reduction in emotional (Cohen's d = - 0.48, 95%CI[- 0.58--0.38]), and social participation challenges (Cohen's d = - 0.45, 95%CI[- 0.53-- 0.36]); small to medium effect size reduction in unemployment (Cohen's d = - 0.21, 95%CI[- 0.33--0.10]), activities of daily living (Cohen's d = - 0.26, 95%CI[- 0.35--0.18]), mobility (Cohen's d = - 0.36, 95%CI[- 0.44--.29]) and communication challenges (Cohen's d = - 0.38, 95%CI[- 0.46--0.3]).
conclusionsOur study indicates that a CBR program may provide positive rehabilitation outcomes for persons with disabilities even in a conflict context, and improve overall well-being of all participants with disabilities, whatever their impairment, individual characteristics and the CBR matrix components considered.
trial registrationISRCTN, ISRCTN50214054 . Registered August 5th 2020 - retrospectively registered.
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