Kumar Ashok, Tandon Praveena, Meratwal Gaurav
Department of Community Medicine, JLN Medical College, Ajmer, Rajasthan, India.
Department of Ophthalmology, Govt Bangur Hospital, Didwana, Rajasthan, India.
Indian J Community Med. 2025 Mar-Apr;50(2):337-343. doi: 10.4103/ijcm.ijcm_440_23. Epub 2025 Feb 1.
Despite progress, there are still gaps and inequalities in achieving universal health coverage (UHC), particularly among marginalized populations such as people with visual disability (VD). This study aimed to evaluate access to disability-related healthcare among people with VD in India.
Data from the Survey of Persons with Disabilities in India, the 76 round of the National Sample Survey (NSS), which was conducted between July 2018 and December 2018, were used in this study. Binomial logistic regression was used to find the association between access to disability-related healthcare and sociodemographic characteristics.
The prevalence of VD in the general population was 0.23%. About 15% of people with VD did not have access to healthcare for disability. Access was lower in the older age group (Adjusted Odds Ratio (AOR) =0.68) than in the younger age group, females (AOR = 0.89), persons with low literacy (AOR = 0.72), low consumption expenditure (AOR = 0.60), and people belonging to the scheduled tribes (STs) (AOR = 0.57). Affordability was the leading reason for poor accessibility. About 55% of people with VD had zero out-of-pocket expenditure (OOPE), 35.8% had monthly OOPE below INR 1000, and 1.3% had monthly OOPE INR >5000.
The study found gaps in access to healthcare in people with VD in India. This population is falling behind in the core elements of UHC, i.e. affordability and inequality. India should adopt a comprehensive strategy that includes age-specific interventions, improved rural access, measures for socioeconomic equity, gender sensitivity, and expanded public health insurance coverage and social security schemes for people with VD.
尽管取得了进展,但在实现全民健康覆盖(UHC)方面仍存在差距和不平等,特别是在视障人士(VD)等边缘化人群中。本研究旨在评估印度视障人士获得与残疾相关医疗保健的情况。
本研究使用了2018年7月至2018年12月期间进行的印度第76轮全国抽样调查(NSS)中的残疾人调查数据。采用二项逻辑回归来寻找获得与残疾相关医疗保健与社会人口学特征之间的关联。
普通人群中视障的患病率为0.23%。约15%的视障人士无法获得残疾医疗保健。老年组(调整后的优势比(AOR)=0.68)的可及性低于年轻组、女性(AOR = 0.89)、低识字率者(AOR = 0.72)、低消费支出者(AOR = 0.60)以及属于在册部落(STs)的人群(AOR = 0.57)。可负担性是可及性差的主要原因。约55%的视障人士自付费用(OOPE)为零,35.8%的人每月自付费用低于1000印度卢比,1.3%的人每月自付费用超过5000印度卢比。
该研究发现印度视障人士在获得医疗保健方面存在差距。这一人群在全民健康覆盖的核心要素,即可负担性和不平等方面正落在后面。印度应采取一项全面战略,包括针对特定年龄的干预措施、改善农村地区的可及性、促进社会经济公平的措施、性别敏感性以及扩大视障人士的公共医疗保险覆盖范围和社会保障计划。