A/HRC/40/32
participation in mainstream education from primary level through to higher and further
education, including resource teachers, in-school speech and language therapies,
occupational therapies and assistive technology.
22.
National practices show that some rehabilitation services can be integrated into the
social protection system. For example, in Germany, distinctions are drawn between medical
rehabilitation assistance, occupational integration assistance and social integration
assistance. The latter includes the provision of non-medical and non-vocational aids,
assistance in developing the practical knowledge and skills necessary for maximum
participation in community life, and assistance in obtaining, adapting, furnishing and
maintaining a home that accommodates specific requirements.
3.
Rehabilitation as a component of community-based inclusive development
23.
As stated above, it should be recognized that not all policies and services enabling
the inclusion of persons with disabilities in the community amount to rehabilitation. The
term “rehabilitation” has come to be used broadly to designate policies aimed at the
inclusion of persons with disabilities or disability-related policies in general. This is linked
to the context in which habilitation and rehabilitation emerged, whereby action and policies
related to persons with disabilities were primarily focused on “fixing” a person’s
impairment as a precondition for their participation in society. Using the term
“rehabilitation” in this broad manner is a throwback to the medical model of disability: the
application of the term in this manner is thus outdated and incompatible with the
Convention, and risks perpetuating stereotypes relating to persons with disabilities.
24.
In recent years, umbrella concepts such as disability-inclusive policies (A/71/314)
and community-based inclusive development have been used to frame a broad range of
disability-related policies and measures, of which rehabilitation in the sense of article 26 of
the Convention is only one of its many elements. For example, community-based
rehabilitation evolved from a strategy that focused on increasing access to rehabilitation
services in the community for persons with disabilities in resource-constrained settings to a
multisectoral strategy within general community development to achieve equity and social
inclusion. While community-based rehabilitation is much broader than rehabilitation within
the meaning of the Convention, the strategy continues to be identified with rehabilitation
services. Community-based inclusive development builds on community-based
rehabilitation, adopting the latter’s principles as the key tool for its implementation. 12
Further research and methodological frameworks from the perspective of the rights of
persons with disabilities are required to better evaluate the outcomes of community-based
rehabilitation and community-based inclusive development.13
III. Unpacking the obligation to provide habilitation and
rehabilitation
A.
Elements of rehabilitation
1.
An individualized approach to rehabilitation
25.
Article 26 (1) of the Convention stipulates that rehabilitation services and
programmes must be based on the multidisciplinary assessment of individual needs and
strengths. Rehabilitation interventions should be based on individual rehabilitation plans
12
13
See www.cbm.org/Community-Based-Inclusive-Development-250825.php.
See, inter alia, Valentina Iemmi and others, Community-based Rehabilitation for People with
Disabilities in Low- and Middle-income Countries: A Systematic Review, Campbell Systematic
Reviews, 2015:15 (Oslo, Campbell Collaboration, 2015); Marie Grandisson, Michèle Hébert and
Rachel Thibeault, “A systematic review on how to conduct evaluations in community-based
rehabilitation”, Disability and Rehabilitation, vol. 36, No. 4 (2014), pp. 265–275; and Sally Hartley
and others, “Community-based rehabilitation: opportunity and challenge”, Lancet, vol. 374, No. 9,704
(28 November 2009), pp. 1,803–1,804.
7
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