Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Room 4009, Education Building, Cape Town, South Africa.
International Centre for Evidence on Disability, London School of Hygiene and Tropical Medicine, London, UK.
Int J Equity Health. 2023 Aug 31;22(1):172. doi: 10.1186/s12939-023-01989-1.
The pandemic has placed considerable strain on health systems, especially in low- and middle-income countries (LMICs), leading to reductions in the availability of routine health services. Emerging evidence suggests that people with disabilities have encountered marked challenges in accessing healthcare services and supports in the context of the pandemic. Further research is needed to explore specific barriers to accessing healthcare during the pandemic, and any strategies that promoted continued access to health services in LMICs where the vast majority of people with disabilities live.
Qualitative in-depth interviews were conducted with persons with disabilities in Ghana, Zimbabwe, Viet Nam, Türkiye (Syrian refugees), Bangladesh, and India as part of a larger project exploring the experiences of people with disabilities during the COVID-19 pandemic and their inclusion in government response activities. Data were analysed using thematic analysis.
This research found that people with disabilities in six countries - representing a diverse geographic spread, with different health systems and COVID-19 responses - all experienced additional difficulties accessing healthcare during the pandemic. Key barriers to accessing healthcare during the pandemic included changes in availability of services due to systems restructuring, difficulty affording care due to the economic impacts of the pandemic, fear of contracting coronavirus, and a lack of human support to enable care-seeking.
These barriers ultimately led to decreased utilisation of services which, in turn, negatively impacted their health and wellbeing. However, we also found that certain factors, including active and engaged Organisations of Persons with Disabilities (OPDs) and Non-Governmental Organizations (NGOs) played a role in reducing some of the impact of pandemic-related healthcare access barriers.
大流行给卫生系统带来了相当大的压力,特别是在低收入和中等收入国家(LMICs),导致常规卫生服务的提供减少。新出现的证据表明,残疾人在大流行期间在获得医疗保健服务和支持方面遇到了明显的挑战。需要进一步研究以探讨在大流行期间获得医疗保健的具体障碍,以及在绝大多数残疾人居住的 LMICs 中促进继续获得卫生服务的任何策略。
作为探索 COVID-19 大流行期间残疾人经历及其在政府应对活动中纳入情况的更大项目的一部分,在加纳、津巴布韦、越南、土耳其(叙利亚难民)、孟加拉国和印度进行了与残疾人进行的定性深入访谈。使用主题分析对数据进行了分析。
这项研究发现,来自六个国家的残疾人(代表了不同的地理分布,具有不同的卫生系统和 COVID-19 应对措施)在大流行期间都经历了额外的困难来获得医疗保健。在大流行期间获得医疗保健的主要障碍包括由于系统重组而导致服务可用性的变化、由于大流行对经济的影响而难以负担护理费用、对感染冠状病毒的恐惧,以及缺乏支持以实现护理的人力资源。
这些障碍最终导致服务利用率下降,从而对他们的健康和福祉产生负面影响。然而,我们还发现,某些因素,包括积极参与的残疾人组织(OPDs)和非政府组织(NGOs),在减少与大流行相关的医疗保健获取障碍的一些影响方面发挥了作用。