| Summary: | This study explores how health beliefs and socio-cultural factors impact on the practice and delivery of Community Based Rehabilitation (CBR) and examines the implications for the theory and practice of physiotherapy. The World Health Organisation has promoted CBR for disabled people in developing countries (WHO, 1981) as an alternative to institutionalised rehabilitation. This study examines the practice of CBR in post-colonial Jamaica. The researcher, a trained physiotherapist who qualified in Jamaica and then worked in the UK conducted ethnographic fieldwork with eight rural families who took part in the 3D Projects programme in Jamaica. She spent a year participating in the life experiences of these participants, observing and conducting contextual interviews. Set against the legacy of imperialism, Jamaica presents the challenge of economic hardship, unemployment, crime and violence and class divide. However, it also offers community resistance and this thesis explores the experiences of families living within rural communities who are caring for children with disability. The study looks at CBR and analyses the role of women and their families caring for children with disability and the implications of community capacity building and the notion of community. Some of the tensions that exist between western ideologies of disability and traditional Jamaican explanations for the causation of disability and then the implications for care are explored. The key role of the Community Rehabilitation Workers (CRW) was recognised. It is suggested that CBR should take into account the cultural and social context of the client, the family and the community. The implications call for the physiotherapist is the need to develop skills of networking, management and negotiation, in order to facilitate the optimal function of the disabled child, the child's family and community. In conclusion, the researcher suggests that there is no one single model of CBR. Physiotherapists are increasingly working in countries other than their own (Noorderhaven, 200 I) and as such, there is a need to develop models of practice which reflect cultural sensitivity in the assessment, planning, implementation and evaluation necessary for the practice of physiotherapy in a CBR programme within a post-colonial society.
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