Vergunst R, Swartz L, Hem K-G, Eide A H, Mannan H, MacLachlan M, Mji G, Braathen S H, Schneider M
Alan J Flisher Centre for Public Mental Health, Department of Psychology, Stellenbosch University, PO Box X1, Stellenbosch, Matieland, 7602, South Africa.
SINTEF Technology and Society, Department of Health Research, PB 124 Blindern, 0314, Oslo, Norway.
BMC Health Serv Res. 2017 Nov 17;17(1):741. doi: 10.1186/s12913-017-2674-5.
Global research suggests that persons with disabilities face barriers when accessing health care services. Yet, information regarding the nature of these barriers, especially in low-income and middle-income countries is sparse. Rural contexts in these countries may present greater barriers than urban contexts, but little is known about access issues in such contexts. There is a paucity of research in South Africa looking at "triple vulnerability" - poverty, disability and rurality. This study explored issues of access to health care for persons with disabilities in an impoverished rural area in South Africa.
The study includes a quantitative survey with interviews with 773 participants in 527 households. Comparisons in terms of access to health care between persons with disabilities and persons with no disabilities were explored. The approach to data analysis included quantitative data analysis using descriptive and inferential statistics. Frequency and cross tabulation, comparing and contrasting the frequency of different phenomena between persons with disabilities and persons with no disabilities, were used. Chi-square tests and Analysis of Variance tests were then incorporated into the analysis.
Persons with disabilities have a higher rate of unmet health needs as compared to non-disabled. In rural Madwaleni in South Africa, persons with disabilities faced significantly more barriers to accessing health care compared to persons without disabilities. Barriers increased with disability severity and was reduced with increasing level of education, living in a household without disabled members and with age.
This study has shown that access to health care in a rural area in South Africa for persons with disabilities is more of an issue than for persons without disabilities in that they face more barriers. Implications are that we need to look beyond the medical issues of disability and address social and inclusion issues as well.
全球研究表明，残疾人在获取医疗服务时面临障碍。然而，关于这些障碍的性质的信息，尤其是在低收入和中等收入国家，却很稀少。这些国家的农村地区可能比城市地区面临更大的障碍，但对此类地区的就医问题知之甚少。在南非，针对“三重脆弱性”——贫困、残疾和农村地区——的研究很少。本研究探讨了南非一个贫困农村地区残疾人获取医疗服务的问题。
该研究包括一项定量调查，对527户家庭中的773名参与者进行了访谈。探讨了残疾人和非残疾人在获取医疗服务方面的差异。数据分析方法包括使用描述性和推断性统计进行定量数据分析。使用了频率和交叉列表，比较和对比了残疾人和非残疾人之间不同现象的频率。然后将卡方检验和方差分析纳入分析。
与非残疾人相比，残疾人未满足的医疗需求率更高。在南非的马德瓦莱尼农村地区，与非残疾人相比，残疾人在获取医疗服务方面面临的障碍要多得多。障碍随着残疾严重程度的增加而增加，并随着教育水平的提高、生活在没有残疾成员的家庭以及年龄的增长而减少。
本研究表明，在南非农村地区，残疾人获取医疗服务比非残疾人更是一个问题，因为他们面临更多障碍。这意味着我们需要超越残疾的医疗问题，同时解决社会和包容性问题。
