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Building future in disability and public health

Disability is extremely diverse. While some health conditions associated with disability result in poor health and extensive healthcare needs, others do not. However, all people with disability have the same general healthcare needs as everyone else, and therefore need access to mainstream healthcare services. By improving access to reliable and accessible health services that allow the best use of available resources, policymakers will enhance health outcomes for people with disabilities. Persons with disabilities have the right to the enjoyment of the highest attainable standard of health without discrimination based on disability.

Provide quality, standard, free and affordable health care and programs to persons with disabilities just like to the remaining population, including in the area of sexual and reproductive health and population-based public health programmes. Provide health services to communities (rural and tribal). Prevent discrimination on health care or health services based on disability. Prohibit marginalisation against persons with disabilities in the provision of insurance. Disability is an aspect of being human. At some point in their life, almost all will briefly or permanently experience disability. About one billion individuals live with some sort of impairment and about 15 percent of the global population. This number is growing. People with disabilities experience poorer health outcomes, have less access to education and work opportunities and are more likely to live in poverty than those without disabilities. People with disabilities often do not receive the healthcare services they rightfully need. Evidence shows that half of the people with disabilities cannot afford healthcare. People with disabilities experience poorer health outcomes, have less access to education and work opportunities and are more likely to live in poverty than those without disabilities.

People with disabilities often do not receive the healthcare services they need. Evidence shows that half of the people with disabilities cannot afford healthcare. To make the world more accessible to people living with disabilities, great progress has been made, but much more work is needed to meet their needs. They were facing lots of barriers in health care like unavailability of services (rural and remote areas), Lack of affordability in health services and transportation. Physical barriers, promotes strategies to ensure that people with disability are knowledgeable about their own health conditions, health services and transport affordability are two main reasons why people with disabilities in low-income countries do not receive much-needed healthcare. Compared to one third of people without disabilities, just over half of people with disabilities are unable to afford healthcare. Lack of service delivery includes ensuring access to effective promotion, prevention, treatment, rehabilitation and palliative health services. Provide a broad range of environmental modifications and adjustments (reasonable accommodation) to facilitate access to healthcare services, empower people with disabilities by providing evidence, training and peer support to optimize their health. Promoting community-based recovery (CBR) to promote access to existing programs for persons with disabilities. Identify communities looking for alternative models of service delivery, such as tailored programs or coordination of treatment to increase healthcare access. 

WHO response:

To improve access to health services for people with disability, WHO has given guidelines like:

  • Guides and supports the Member States to increase awareness of disability issues, and promotes the inclusion of disability as a component in national health policies and programmes.

  • Facilitates data collection and dissemination of disability-related data and information.

  • Develops normative tools, including guidelines to strengthen healthcare.

  • Builds capacity among health policymakers and service providers.

  • Promotes scaling up of CBR. 

  • Promotes strategies to ensure that people with disability are knowledgeable about their own health conditions, and that health-care personnel support and protect the rights and dignity of persons with disability.

CASE STUDY

A person with Muscular Dystrophy

According to Municipal rules, all people with disabilities have the right to access in hospital buildings and public toilets but often that is not possible. Consider any buildings, the government provides an area for wheelchair access in all sectors but they are building a small room in that particular place. They specify the area only at the time of consent from the government after that they convert it into a room. This person said that, “there was no accessibility for a wheelchair or RAMP when he visited a bank. Many people were face this difficulty in places like ATM counters which necessarily need sliding doors and ramps for flexible access. It means that they have to do it themselves without bothering others. But there is a rule that all ATMs should be wheelchair friendly but banks are rarely executing this provision into action. Old age people are affected more due to this situation. Doctors look like they are not familiar with muscular dystopia. Now PHC's are much better than private hospitals. Need to improve counselling departments in many hospitals and don’t have any support, care and love from the doctor’s” 

When we compared WHO rules and health care facilities for persons with Disabilities’ with Kerala context, there was no development for them. Only a few schemes were launched for their benefits. From the above case study, the person mentioned that there is no access for wheelchair and RAMP. WHO also promotes the strategies to ensure that people with disability are knowledgeable about their own health conditions but here many of them don’t have any idea about their health conditions, problems they are facing, they are always depending on others for help. Empower people with disabilities by providing evidence, training, and peer support to optimize their health. It is a major component for Persons with Disability to improve their physical and mental health. WHO also mentioned the barriers in their health care to make new interventions for them. Like unavailability of services (rural and remote areas), in the case of Kerala, in many villages, they don’t have health access for them. Lack of affordability in health services and transportation, this is related to government buses because none of the buses have support of access for wheelchair. So these are the problems faced by People with Disability in Kerala Context.

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