Community-Based Rehabilitation: Monitoring as Empowerment

Resumen

The learning community experiences of a team of practitioners and academics provide the context for a discussion of the role of empowerment in monitoring community-based rehabilitation programmes (CBR). The theme is monitoring as a source of empowered knowledge. The idea of empowerment is traced from the origins of CBR as a societal response to global injustice in health care, to it?s complex and unfinished expression in CBR practice, and on to its problematic impact on traditional monitoring practices. It is suggested that knowledge systems are socially constructed to serve the powerful, and that other social constructions are necessary to serve programmes designed to empower the oppressed. An innovative path is suggested for the development of an appropriate monitoring tool in a social justice frame that would strike a balance between external support and local control in CBR. The translation of empowerment into such a knowledge system is described through the developmental history of a monitoring toolkit built within the social justice frame. Designing and building the CBR Monitoring Manual & Menu brought academics and practitioners together as a learning community. The tool and community have completed the first iteration towards best and evidence-based monitoring, but more importantly, their work continues through on-going, and empowered discourse. The reflection on monitoring and empowerment resolves in lessons learned and an understanding that empowered knowledge lies in the people who design the system that defines it, and that monitoring is empowerment when people, process, and knowledge are united in community.