Tunafasi Program in Eastern DR Congo
The overall goal of the Tunafasi - Swahili: ‘we all have a place’ - program is to improve the quality of life of children and youth with disabilities and their families, promote a disability inclusive environment, and reduce birth defects, maternal, neonatal and child mortalities through strengthening the community structures and making the state accountable. The program is based on Karuna Nepal’s successful Inspire2Care* program, and is being contextualized by the Congolese Ngo ADED (Appui au Développement de l’Enfant en Détresse) in the eastern Democratic Republic of Congo since 2019.
Overall aims Tunafasi:
- To integrate Community Based Rehabilitation (CBR) into the existing public system in DRC: enhancing access to healthcare, education, livelihoods, and social inclusion, and empowerment (WHO CBR matrix).
- To strengthen the existing healthcare system, including maternal, neonatal, and child healthcare services to prevent birth defects and risks of disabilities.
- To strengthen the accountability and improve the public system and increase the resilience of communities to promote an inclusive and accessible environment.
Core Tunafasi Program DRC
From the start, the Tunafasi program has been designed with a clear exit strategy: strengthening public systems, empowering Organizations of Persons with Disabilities (OPDs), and enabling communities and families to integrate CBR and prevention without long-term reliance on external donors. The approach works through provincial authorities, municipalities, community leaders, families, and local structures embedding CBR into year plans and budgets of the local municipalities, health zones and provinces. This ensures long-term ownership, accountability, sustainability, and system change.
A core principle is ownership and accountability. The government covers the salaries of Community Based Rehabilitation Facilitators (CBRFs), appoints physiotherapists, and integrates disability data into the national system. Communities are organized through self-help (Tushiriki) groups and community health volunteers support the CBRFs in their work. The program is coordinated through a multisectoral CBR Steering Committee that brings together officials and stakeholders from different sectors. ADED acts as a catalyst and technical partner, supporting authorities and community structures strengthen their roles rather than replacing them. CBRF's are the backbone of the program. They are responsible for identifying and supporting children and youth with disabilities and their families, connecting them to essential services to improve their lives.
Scope of Tunafasi DRC
The implementation of the contextualization of the Inspire2Care model into the Tunafasi Program started in Uvira in 2020. In 2023, the program was scaled to two new health zones Nyiragongo (Goma area), and Fizi (Baraka area) implemented by partner organization AJEPAD (Association des Jeunes Actifs pour la Paix et le Développement). The last health zone that was included is Bagira (Bukavu area) that started with the preparation phase of the implementation at the end of 2024. These areas are all located in North- and South-Kivu, eastern DRC, which have been affected by conflict and war for decades, as the area is rich in minerals and where several military groups are fighting to capture control. Resulting in that approximately 6.7 million people have been displaced (4.6 million displaced in North and South Kivu only).
Even amid the insecurity and displacement in eastern DRC, essential services have continued because ADED acts as a catalyst — working through existing public systems (health zones, schools, hospitals), alongside Organizations of Persons with a Disability, territorial authorities, and, above all, the parents of children with disabilities.
Community Based Rehabilitation (CBR) used to be under the Ministry of Health in DRC. As of the year 2025, a new policy change places CBR under Multi-Sectoral Coordination. Policies and laws in DRC on disability and CBR are well written out, but lack actual implementation on the ground. In DRC, there are a total of 522 health zones, in which CBR is implemented in 34 health zones, only with a focus on the medical health component. Through the work and effectiveness of ADED and AJEPAD, Uvira, Nyiragongo (Goma), Fizi (Baraka), and Bagira (Bukavu), are the first 4 health zones in North- and South-Kivu to include all 5 components of CBR and prevention, with governmental and community ownership and accountability at its core. In the entire Provinces of North and South Kivu, there are a total of 68 Health Zones. ADED's ambition is to scale up the Tunafasi program to the remaining Health Zones in North and South Kivu in the years to come (10 new health zones in the next five years) under the assumption that after 2030 the province and municipalities are well placed to roll-out the program by themselves.
TUNAFASI PROGRAM AREAS EASTERN DRC
Tunafasi Uvira
Since 2019, the program has been implemented in the 22 health centers (government health clinics) of the Healthzone of Uvira. At the start of the program, a total of 1.200 children and youth with disabilities, and their families, were identified. 21 CBRFs were selected to coordinate and supervise the needs of children and youth with disabilities in Uvira. At the end of 2024, a new door-to-door survey was done in which a total of 3.428 children and youth were identified, out of which 1.458 children and youth were already supported by the Tunfafasi program. The increase is mainly due to migration (climate & conflict), new births, and previously unrecognized children due to stigma or skepticism in the community. Due to the increase, the local government and CBR steering committee made the decision to double the amount of CBRFs, resulting in a total of 42 CBRFs that are responsible for the supervision of this increased number of children and youth with disabilities.
Tunafasi Nyiragongo (Goma)
Since April 2023, the program started in the Nyiragongo Health Zone, focussing on 5 health centers. A total of 554 children and youth with disabilities were identified, who are now included into the program.
Tunafasi Fizi (Baraka)
Since April 2023, the program also started in the Fizi health zone, where partner organization AJEPAD supports the implementation process across 6 health centers. A total of 1.016 children and youth with disabilities were identified.
Tunafasi Bagira (Bukavu)
At the end of 2024, the preparation phase of the scale up to Bagira health zone in Bukavu started, which is the capital city of South Kivu. This program is supported by the Liliane Foundation and Impaction/Tunafasi. During the preparation phase, a door-to-door survey was done to identify a total of 1,926 children and youth with disabilities.
Sidebar Explainers:
What is Community-Based Rehabilitation (CBR)?
Community-Based Rehabilitation (CBR) is an approach developed by the World Health Organization (WHO) to ensure that persons with disabilities can participate fully in society. It brings together five key areas that shape a person's well-being: health & prevention, education, livelihoods, social inclusion, and empowerment. Instead of creating parallel systems, CBR needs to be included into existing public services — such as schools, health centers (hospitals), and other public services — so that they become more accessible for persons with a disability. By involving families, community leaders, and local government, the integration of CBR works towards the removal of physical, social, and institutional barriers and promotes equal rights and opportunities for people with disabilities.
Who are Community-Based Rehabilitation Facilitators (CBRFs)?
Community-Based Rehabilitation Facilitators (CBRFs) are trained community workers or health personnel, who are employed by their municipality to support children and youth with disabilities. They identify children with disabilities by door-to-door surveys, visit families at home, and help determine what each child needs to thrive. CBRFs connect families to health care, rehabilitation, education, income and social services, while also advocating for disability inclusion and accessibility among community actors, such as teachers, school directors, health workers, and local authorities. As the backbone of the program, they ensure that children and youth with disabilities receive the right support within the community and from the government authorities. Their salaries are paid by the state, which means that they are integrated into the existing social services system.
What is the DPRP model?
DPRP is a holistic, cost-effective, evidence-based and scalable model developed by Karuna Foundation in Nepal. It aims to improve the lives of children and adults with disabilities by placing them at the center of a community-driven and government support system. Inspired by the WHO CBR approach, Inspire2Care combines five core pillars — health, education, income, social participation, and empowerment — with an extra focus on preventing birth defects and childhood disabilities through quality maternal care, safe delivery, and early diagnosis. The model is designed to be fully owned and run by local governments and communities. By working with families, forming self-help groups, and mobilizing local resources, DPRP works towards a sustainable system that continues after external funding ends.
