[Evaluation of community-based rehabilitation programs in Ghana and Benin].

This article describes two community-based rehabilitation programs set up for disabled persons in Ghana and Benin in the early 1990s. Both programs were based on the model described by the World Health Organization but differed greatly with regard to implementation. This difference had great impact on the respective effectiveness, efficiency and viability. Analysis of 624 disabled persons ranging in age from 0 to 30 years showed better progress in the Beninese group for all areas considered with a resulting improvement in quality of life. Assessment of the cost-effectiveness indicated that spending was higher and less effective in Ghana for globally less benefit than in Benin. Data also suggested that differences in implementation impacted program viability since the Ghana program collapsed in 1999 while the Beninese program is ongoing. The authors speculate that the differences in the two programs were related to failure to observe the basic principles of any community development strategy in Ghana. For successful community response to difficult local situations, populations require technical assistance from outside sources. National authorities must provide players at both lower levels with the necessary resources including subsidies, training, salaries, planning, monitoring and legislation. These basic rules were largely applied in Benin but almost completely ignored in Ghana.