中東ヨルダンにおける障害当事者への地域に根ざしたリハビリテーション遂行状況と課題

Current situation and challenges regarding Community-Based Rehabilitation for persons with disabilities in Jordan

要旨：Community-Based Rehabilitation（以下，CBR）は，世界90ヵ国以上で実施されているが，開発途上国の障害者支援には課題が多い．本研究では，ヨルダンのCBR遂行状況とその課題を明らかにした．CBR実務者9名に半構造化面接を実施後，収集データを内容分析しWHOのCBRマトリックスと対比した結果，「CBRの解釈」，「CBRの実施状況」，「CBR展開上の困難点」，「CBRプロジェクトの将来展望」の4カテゴリー，24のサブカテゴリーが抽出された．研究参加者のCBR認識は障害当事者へのエンパワメントが希薄であり，国際協力での医療従事者は現地CBR実務者と協働して障害当事者のエンパワメントを組み込む具体的な方法を支援する必要性が示唆された．

　Introduction: Community-Based Rehabilitation (CBR) is currently implemented in over 90 countries. However, support programs for Persons With Disabilities (PWDs) have many challenges in developing countries. The present study attempts to clarify the current situation and challenges of the provision of support for PWDs by CBR workers in Jordan. Subjects and Methods: Nine CBR workers in Jordan underwent semi-structured interviews between December 2011 and August 2013, and qualitative content analyses were performed to assess the situations and challenges of the subjects. The results were analyzed using a Community-Based Rehabilitation matrix on the themes of the subjects' current CBR programs. Results: The current situations of CBR programs by the CBR workers in Jordan were categorized under four main themes and 24 sub-themes: “Interpretation of Community-Based Rehabilitation”, “Situation of Community-Based Rehabilitation in his/her programs”, “Difficulty in his/her Community-Based Rehabilitation programs” and “Prospects for the future in his/her Community-Based Rehabilitation program”. Conclusion: There is insufficient recognition of CBR of participants for the empowerment of PWDs. Therefore, it is essential that health professionals provide concrete methods to empower persons with disabilities.