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南非实施《联合国残疾人权利公约》健康和康复条款的障碍。

Barriers to the Implementation of the Health and Rehabilitation Articles of the United Nations Convention on the Rights of Persons with Disabilities in South Africa.

机构信息

Centre for Global Health, Trinity College Dublin, Dublin 2, Ireland.

School of Psychology, Trinity College Dublin, Dublin 2, Ireland.

出版信息

Int J Health Policy Manag. 2017 Apr 1;6(4):207-218. doi: 10.15171/ijhpm.2016.117.

Abstract

BACKGROUND

The United Nations (UN) Convention on the Rights of Persons with Disabilities (CRPD) is a milestone in the recognition of the human rights of persons with disabilities, including the right to health and rehabilitation. South Africa has signed and ratified the CRPD but still has a long way to go in reforming policies and systems in order to be in compliance with the convention. This paper seeks to fill a gap in the literature by exploring what the barriers to the implementation of the health and rehabilitation articles of the CRPD are, as identified by representatives of the disability community.

METHODS

This investigation used a qualitative, exploratory methodology. 10 semi-structured interviews of a purposive sample of representatives of disabled persons organizations (DPOs), non-governmental organizations (NGOs), and service providers in South Africa were conducted. Participants were drawn from urban, peri-urban, and rural settings in order to reflect diverse perspectives within South Africa. Data was analysed using a multi-stage coding process to establish the main categories and relationships between them.

RESULTS

Six main categories of barriers to the implementation of the health and rehabilitation articles of the CRPD were identified. Attitude barriers including stigma and negative assumptions about persons with disabilities were seen as an underlying cause and influence on all of the other categories; which included political, financial, health systems, physical, and communication barriers.

CONCLUSION

The findings of this study have important implications for strategies and actions to implement the CRPD. Given the centrality of attitudinal barriers, greater sensitization around the area of disability is needed. Furthermore, disability should be better integrated and mainstreamed into more general initiatives to develop the health system and improve the lives of persons living in poverty in South Africa.

摘要

背景

《联合国残疾人权利公约》(CRPD)是承认残疾人包括健康和康复权利的一项里程碑式的公约。南非签署并批准了该公约,但在改革政策和制度以符合该公约方面仍有很长的路要走。本文旨在通过探索残疾社区代表所确定的实施 CRPD 健康和康复条款的障碍,填补文献中的空白。

方法

本研究采用定性、探索性方法。对南非残疾组织(DPO)、非政府组织(NGO)和服务提供者的具有代表性的 10 名参与者进行了 10 次半结构化访谈。参与者来自城市、城乡结合部和农村地区,以反映南非的多样化观点。使用多阶段编码过程对数据进行分析,以确定主要类别及其之间的关系。

结果

确定了实施 CRPD 健康和康复条款的 6 个主要障碍类别。态度障碍,包括对残疾人的污名化和负面假设,被视为所有其他类别的潜在原因和影响因素;其中包括政治、财务、卫生系统、物理和沟通障碍。

结论

本研究的结果对实施 CRPD 的策略和行动具有重要意义。鉴于态度障碍的核心地位,需要在残疾领域进行更多的敏感性培训。此外,应更好地将残疾纳入更广泛的卫生系统发展和改善南非贫困人口生活的倡议中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/78f9/5384983/88dc7fc478d6/ijhpm-6-207-g001.jpg

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