Health

Persons with disabilities have the same need to access health services as others, which requires that all mainstream health services must be accessible. Persons with disabilities may also have additional disability-specific needs that require targeted health and rehabilitation programs, including for example the provision and fitting of assistive devices.

The United Nations Convention on the Rights of Persons with Disabilities recognises that persons with disabilities have the right to equal access to mainstream health services (Article 25) including health-related rehabilitation programs (Article 26).

However evidence (including that outlined in the World Report on Disability) suggests that persons with disabilities have unequal access to health services and experience poorer levels of health than the general population. In addition, socio-economic factors such as poverty, lower employment and education rates, stigma, social exclusion and lack of social protection further influence health inequality among persons with disabilities.

Donors and development actors must consider the needs of persons with disabilities in efforts toward achieving accessible health infrastructure and communications, health systems strengthening and workforce planning in support of accessible mainstream and targeted health services. A range of inclusive strategies in existing policies, systems and services are needed to close the gap in access to health care between persons with and without disabilities.

Resources in this section include international action plans, policy briefs, guidelines, resource manuals, case studies and research and reviews which can support inclusive health strategies.

See also Assistive Devices, Community Based Rehabilitation, Early Intervention, Children and Youth with Disabilities, Accessible Infrastructure and Communications.

DFAT & Indo-Pacific Centre for Health Security (2023) Health Security Initiative Guidance Note: Supporting disability inclusion through DFAT health security investments

This guidance note on disability inclusion in DFAT’s health security investments has been developed to assist DFAT program managers and implementing partners ensure projects in the region are contributing to greater health outcomes for people with disabilities. It includes a checklist and key guiding questions to identify opportunities to embed disability inclusion across the program cycle for health security programs.

the World Bank (2022) Disability-Inclusive Health Care Systems: Technical Note for World Bank Task Teams.

This is a guidance note on designing and delivering disability-inclusive healthcare services. It provides the rationale for disability inclusion, tips for engaging in dialogue, information and examples on disability-inclusive practices and operations, and specific guidance on integrating disability into health service programming and delivery.

World Health Organisation (2022) Global Report on health equity for persons with disabilities

the WHO Global report on health equity for persons with disabilities demonstrates that while some progress has been made in recent years, the world is still far from realizing this right for many persons with disabilities who continue to die earlier, have poorer health, and experience more limitations in everyday functioning than others. These poor health outcomes are due to unfair conditions faced by persons with disabilities in all facets of life, including in the health system itself. Countries have an obligation under international human rights law to address the health inequities faced by persons with disabilities. The WHO Global report on health equity for persons with disabilities documents the evidence on health inequities faced by persons with disabilities, and the contributing factors; and, makes evidence-based recommendations for country-level actions to address these gaps.

World Health Organization. Regional Office for the Western Pacific (2020) Disability-inclusive health services toolkit : a resource for health facilities in the Western Pacific Region

The Disability-inclusive Health Services Toolkit supports the rights of people with disabilities to have the same access to health services as people without disabilities. The Toolkit provides practical guidance to managers and staff of health-care facilities and services, health policy-makers, and NGOs on identifying and addressing barriers to health information and services. The Toolkit supports the achievement of universal health coverage (UHC) by ensuring everyone can access health information and can benefit equally from health services.

Kuper H & Heydt P. (2019) The Missing Billion. Access to health services for 1 billion people with disabilities.

This report brings together existing knowledge on access to health services for people with disabilities. It highlights the barriers to accessing health services across the patient journey, providing a human experience perspective. It also provides practical principles and immediate actions for change, and outlines key recommendations intended to improve access to health for people with disabilities.

UN Dept of Economic and Social Affairs (UNDESA) Div for Social Policy & Development (DSPD) (2016) Toolkit on Disability for Africa: Inclusive health services for persons with disabilities

The United Nations Department of Economic and Social Affairs (UNDESA), Division for Social Policy and Development (DSPD) created a Toolkit on Disability for Africa in 2016. Whilst this toolkit is designed to inform trainings and specifically targets African countries, the information within the Disability Inclusive Health Module is universal and helpful in determining strategic directions in the design of disability inclusive health systems. The module gives a succinct summary informed by the Convention on the Rights of Persons with Disabilities, outlining the barriers to health for people with disabilities in low and middle income countries and practical strategies to build disability inclusive health systems. This concise resource is helpful in program design and training. It is one of few resources that appropriately address the need for disability inclusion within mainstream health services as well as the need for access to specialised health services using a rights based approach.

World Health Organisation (2010) Community Based Rehabilitation (CBR) Guidelines: Health component

The health component of the Community Based Rehabilitation (CBR) Guidelines provides guidance on how health systems and services can be shaped to promote the health of people with disabilities across five key areas of health promotion, prevention, medical care, rehabilitation and assistive devices. These guidelines provide advice on how CBR programs can work closely with the health sector and individuals and families to ensure access to health services for people with disabilities. Barriers to health and inclusive health strategies are discussed as well as case studies within each of the five key areas from a range of regions.

World Health Organization and World Bank (2011) World Report on Disability

The World Report on Disability presents the best available evidence in relation to the situation of persons with disabilities globally. Chapter 3 of this report addresses issues around barriers faced by persons with disabilities in accessing general health care and Chapter 4 addresses issues relating to rehabilitation. These chapters, read in conjunction with the recommendations set out in Chapter 9 will provide a basis for policy and programming responses on disability inclusive health care. The report is also useful in showing how multi-sectoral approaches are needed for effective outcomes.

CBM Australia (2013) End the Cycle Indepth: Healthcare

This 2 minute video, presented by Australian paralympian, Grant “Scooter” Patterson, provides a high level overview of the need for disability inclusive healthcare. It outlines the various barriers to healthcare faced by persons with disabilities, and the social and economic impacts this can have. It calls for persons with disabilities to be involved in designing appropriate health services.

A partnership between Transaid, Medicines for Malaria Venture (MMV), and other consortium partners completed a 12 month malaria project in Serenje district in Zambia. Child fatality reduced from 8% to 0.25% - 3 recorded deaths to the 97 expected deaths during this time period. A two-pronged approach was used: 1) rapid analysis by field health care workers who could identify and treat children with malaria, and 2) communities were equipped with specially designed bicycle ambulances with a flat, bed-like cart that tows the child to speed up the journey to hospital.

WHO (2021) Persons with disabilities share their experiences of accessing health services

Features the voices of people with disabilities across India, Kenya, Nigeria and Zambia to share their experiences of accessing health services.

WHO (2021) Persons with disabilities share their experiences of accessing health information

Features the voices of people with disabilities across India, Kenya, Nigeria and Zambia to share their experiences of accessing health information and sexual and reproductive health services.

Picture of two smiling young men. One, who uses a walking stick , has his arm around his friend. His friend has no arms.

Photo: Tamara Jolly, 2009

Tanish* and Aeshan* are close friends who live in India. After some initial training, they now help train community health staff at the Uttarakhand Cluster training program on strategies to include those with disability in health programs. (*pseudonyms used) Copyright: Community Health Global Network Uttarakhand Cluster