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残疾人在新冠疫情期间面临的医疗系统准入挑战增加。

Health system access challenges of people with disabilities increased during Covid-19 pandemic.

机构信息

College of Arts and Sciences, Whitworth University, Spokane, United States.

出版信息

Disabil Health J. 2023 Jul;16(3):101446. doi: 10.1016/j.dhjo.2023.101446. Epub 2023 Jan 26.

Abstract

BACKGROUND

People with disabilities (PWDs) have unequal access to health services compared with the general population and this disparity is worsening during the Covid-19 pandemic. Evidence supports the importance of policy development and legislation for addressing the unmet health needs of PWDs, but little is known about the impact of these efforts in Ghana.

OBJECTIVE

This study examined health system experiences of PWDs in Ghana within the context of existing disability legislation and related policies prior to and during the Covid-19 pandemic.

METHODS

Narrative analysis of data from qualitative research approaches of focus group discussions, semi-structured interviews, and participant observations were used to examine the experiences of fifty-five PWDs, four staff of the Department of Social Welfare, and six leaders of disability-focused non-governmental organizations in Ghana.

RESULTS

Structural and system barriers hinder PWDs access to health services. Bureaucratic bottlenecks hinder PWDs access to Ghana's free health insurance policy and health workers' disability stigma impedes accessibility to health services.

CONCLUSIONS

Access barriers and disability stigma increased accessibility challenges for PWDs in Ghana's health system during the Covid-19 pandemic. My findings support the need for increased efforts toward making Ghana's health system more accessible to address health disparities experienced by PWDs.

摘要

背景

与一般人群相比,残疾人士(PWDs)获得医疗服务的机会不平等,而在新冠疫情期间,这种差距正在扩大。有证据表明,制定政策和立法对于解决残疾人士未满足的健康需求至关重要,但对于加纳在这些方面的努力所产生的影响却知之甚少。

目的

本研究在新冠疫情之前和期间,从现有的残疾立法和相关政策角度出发,考察了加纳残疾人士在卫生系统中的体验。

方法

采用焦点小组讨论、半结构化访谈和参与者观察等定性研究方法的叙述性分析,研究了加纳的 55 名残疾人士、4 名社会福利部门工作人员和 6 名残疾非政府组织的领导人的经历。

结果

结构性和系统障碍阻碍了残疾人士获得医疗服务的机会。官僚主义瓶颈阻碍了残疾人士获得加纳免费医疗保险政策的机会,而卫生工作者的残疾污名则阻碍了他们获得医疗服务的机会。

结论

在新冠疫情期间,加纳卫生系统中的准入障碍和残疾污名将残疾人士面临的健康服务获取挑战进一步加剧。本研究结果支持需要加强努力,使加纳的卫生系统更具包容性,以解决残疾人士所经历的健康差距。

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Disability, Ethics, and Health Care in the COVID-19 Pandemic.《COVID-19 大流行中的残疾、伦理与医疗保健》
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