Community Approaches to Handicap in Development (CAHD) is a program concept that was developed in Bangladesh by the Centre for Disability in Development (CDD) in collaboration with Handicap International and CBM. CAHD was developed to address the need for a framework to address the inclusion of disability issues in development programs and became a standard approach over the last 10 years in Bangladesh and abroad.

The success of CAHD and its popularity amongst practitioners influenced the World Health Organisation to adapt their Community Based Rehabilitation (CBR) approach to make it more relevant and applicable to disability inclusive development. The new CBR guidelines have adopted many of the CAHD practice elements and therefore CDD now uses these to guide its work. However, some further information on CAHD is provided below given its extensive use in Bangladesh for many years.

 Theory behind CAHD
Development work is primarily focused on the eradication of poverty and on changing the attitudes and practices of the community. CAHD recognises that impairment and disability are integral to development issues due to their close connection to poverty and so aims to include them in the ongoing activities of mainstream development organisations.

 Vision of CAHD
The vision of CAHD is to establish activities that will minimise the negative impacts of impairment and disability, by creating changes in attitudes to counter the existence of or to eliminate negative attitudes.

To achieve this vision CAHD programs must effectively and efficiently implement activities that will:

  • Change the attitudes of people and their organisations to more equitably share resources with all people, especially with those who are living with disability.
  • Change the social environment and the attitudes of people and organisations to eliminate the barriers that exclude persons with disabilities from participation, and which lead to minimal if any assistance for them.
  • Reduce the impact of impairment and disability on individuals and their families by helping to prevent disability occurrence and providing needs-based services.

How CAHD creates change
CAHD focuses on changing the perspectives of people and organisations, and to do this it is essential to change knowledge, attitudes and practices:

  • Knowledge:Changing perspectives requires creation of knowledge by providing information and creating experience. In CAHD, this information transfer is called social communication and experience is gained through participating in inclusion activities.
  • Attitudes:Once knowledge is assimilated and combined with experience, it results in specific attitudes or ways of thinking about certain topics.
  • Practice: Ultimately, this new-found knowledge and way of thinking will change practice – this is the key objective of CAHD.

The components of CAHD

CAHD is comprised of four components on which interventions are based and it is essential that there are simultaneous activities in all of these components:

  1. Social Communication (Awareness and attitudinal)

Providing knowledge to people and organisations about:

  • Causes of impairment, disability and negative attitudes.
  • Roles of family members and organisations, in creating barriers and restrictions to participation.
  • Activities that will prevent impairment and disability.
  • Rehabilitation practices that will minimise the impact of impairment and maximise the personal development of persons with disabilities.
  1. Inclusion and Rights (Inclusion and participation in development and socio-political activities, enjoying equal status and rights)

Providing persons with disabilities with an equal opportunity to access their rights as citizens and to participate in all family and community activities enables:

  • Persons with disabilities to improve the quality of their lives.
  • People and their organisations to have positive experiences with persons with disabilities, which will change their attitudes towards them.
  • Organisations to include persons with disabilities in their existing programs to give them equal access to education, economic and health opportunities.
  • Persons with disabilities to promote their right to play active roles in family, community, social and economic activities.
  • National organisations to advocate for legislation, policy and regulations which recognise the rights of persons with disabilities.
  1. Rehabilitation (Therapeutic Interventions)

Providing assistance to people who have impairments to minimise functional difficulties and maximise their personal development by:

  • Providing basic rehabilitation services in the community.
  • Providing referrals to other services and transferring skills to family members or care givers to meet the special needs of persons with disabilities.
  • Providing assistive devices to minimise functional limitations and enable persons with disabilities to participate more in society.
  • Adapting working and living environments to make them more accessible.
  1. Management

An organisational function necessary to make sure that the previous three activities are implemented simultaneously and that these activities are relevant, efficient and effective by:

  • Developing a monitoring, research and evaluation system.
  • Building the capacity of local partners.
  • Including persons with disabilities, their families and the community in the design and monitoring, research and evaluation process to ensure the accountability of the CAHD approach.
  • Developing and facilitating networks.
  • Documenting the development and evaluating the impact of the CAHD approach.
  • Using monitoring, research, documentation, and evaluation information to improve the CAHD approach.

 CAHD Sectors

CAHD is directed at each sector or level in society, which can be categorised as follows:

  • PRIMARY SECTOR:The micro-level, family situations, where people live out most of their lives.
  • SECONDARY SECTOR:The first macro-level where people, as members of organisations, work to provide direct governance, goods and/or services and create social change in the primary sector.
  • TERTIARY SECTOR:The second macro-level where people, as members of organisations, work to provide indirect governance and services, manufacture goods and create social change in the primary sector.