The Influence of Micro-Foundations of Institutional Logic on Community-Based Rehabilitation (CBR) Programs in Thailand

Abstract

This article illustrates the role of  microfoundations of institutional logics  as the mediators shaping behavior and interactions within Community-Based Rehabilitation (CBR) Programs, which influences the conceptual framework and practical implementation encompassing both material and symbolic aspects. The findings explain that the CBR Programs consists of seven micro-institutes constituting the foundations of institutional logic. These include local government agencies, health-promoting hospitals, communities, people with disabilities (PWDs), families, corporations, and non-governmental organizations (NGOs). The diversity of these micro-foundations coupled with the authority of state regulations and medical professionals have influenced the CBR Programs in three phenomena in order to maintain the gaps between material and symbolic practices, including the temporary decoupling of the logic, the creation of diverse practices in CBR activities, and the reinforcement of embedded logic, conflict and competing logics at macro- and micro-level. Since the institutional powers from state and professional institutes at the micro-level strictly dominate the formal practice framework proposed by the CBR Programs, therefore, the intention and objective of CBR are providing welfare and medical rehabilitation rather than empowering PWDs organizations. This dominance of states and professionals impedes the program to create a hybrid organization to meet the community context. This article recommends that the government agency should define and provide authority structure to the CBR institution and to formulate strategies in order to transform CBR into a community -centric institution mobilizing the CBR Programs to benefit other communities across Thailand. In addition, the state agencies and professional organizations should clarify the concept of empowerment within the CBR Programs. This collaborative effort should define the role of government organizations in creating a new framework to enhance the quality of life for PWDs within the community.