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M. Marella, E. L. Lamoureux, J. E. Keeffe; Evaluation Framework for Vision Related Community Based Rehabilitation Services. Invest. Ophthalmol. Vis. Sci. 2010;51(13):6005.
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© ARVO (1962-2015); The Authors (2016-present)
To validate a framework designed to assess the effectiveness of vision related community based rehabilitation (CBR-VI) services.
A framework was designed to evaluate 4 components of CBR-VI: service delivery, program management, linkages with stakeholders and outcomes. Indicators (n=129) for each component were derived from the literature. The framework was used to assess effectiveness of CBR-VI in Fiji and Cambodia. Data were collected by interviews with clients, family members, CBR staff and other stakeholders. The responses were categorised into the themes of the framework for qualitative analysis using NViVO. The indicators were considered to be valid if they were measurable (feasible to obtain data) and relevant (appropriate to the context of services). Reliability was assessed using triangulation between participants.
In both countries 13 (10.1%) indicators could not be measured, 6 (4.6%) were not relevant and 15 (11.6%) could not be tested for reliability. Excluding common indicators that did not fit the criteria, overall 116 (89.9%) of the proposed indicators were valid and 114 (88.4%) could be tested for reliability. Additionally, each country had different sub-sets of indicators that did not fit the criteria. In Fiji, 101 of 129 (78.2%) indicators were measurable, 117 (90.6%) were relevant and reliability could be tested for 100 (77.5%) indicators. When the same framework was used in Cambodia, 115 of 129 (89.1%) indicators were measurable, 122 (94.5%) were relevant and reliability could be tested for 113 (87.5%) indicators. Discrepancies in the numbers were due to different designs of the two programs. Using client satisfaction as a measure of success, the critical themes identified in both countries for an effective CBR-VI were: functional independence, income generation, empowerment, social inclusion, systematic monitoring and follow-up systems, involvement of family and community, linkages with government and other sectors. Services in both countries had limitations with coverage and financial sustainability.
Most of the proposed indicators were valid in the framework to assess the effectiveness of CBR-VI services. Their applicability across more countries needs to be further tested.
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