Access to health care for persons with disabilities in rural South Africa

Vergunst, Richard; Swartz, Leslie; Hem, Karl-Gerhard; Eide, Arne Henning; Mannan, Hasheem; MacLachlan, Mac; Mji, Gubela; Braathen, Stine Hellum; Schneider, Margie

doi:10.1186/s12913-017-2674-5

Cited by 106 publications

(117 citation statements)

References 45 publications

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“…Rehabilitation service provision is an issue especially in the low and middle-income countries, where 80% of the global population of the one billion PWDs live 18 . Persons with disabilities have been shown to have a lower quality of life as a result of poorly addressed impairment, activity limitations, and participation restrictions 18 . Attitudinal, political, financial, communication, physical, and health system barriers also impact the lives of PWDs 19,20 .…”

Section: Literature Review Rehabilitation At a Primary Health Care Lementioning

confidence: 99%

Occupational therapy services and perception of integration of these at primary healthcare level in South Africa

Jejelaye¹,

Maseko²,

Franzsen³

2019

S. Afr. j. occup. ther.

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Background: Literature indicates that access to rehabilitation services in South Africa is limited. Recent policy documents by the National Department of Health related to disability and rehabilitation propose the integration of occupational therapy services in primary healthcare (PHC). However, the implementation strategies concerning integration are not clear as there is inadequate evidence locally on the occupational therapy service provision in PHC even though there is growing evidence internationally.Purpose: This study sought to determine the services provided by occupational therapists in PHC and to explore the perceptions of the occupational therapists on the integration of occupational therapy services within the PHC reengineering streams of the National Health Insurance (NHI).Method: A two-phase explanatory sequential mixed method strategy was utilised in this study. A quantitative survey was sent to members of the occupational therapy professional association and an organisation of professionals providing rehabilitation services in rural communities. Qualitative data were then collected using semi-structured interviews with five therapists who completed the survey.Findings: Findings from this study showed there is increasing alignment of occupational therapy services in PHC with the communitybased rehabilitation (CBR), the Social Model, the International Classification of Functioning, Disability and Health (ICF), and the Medical Model using client self-management and case-management intervention approaches. The majority of occupational therapists are currently based in district hospitals (42%), community health centres (16%), community organisations (8%), and clinics (8%). Those working in the community indicated they work in a multidisciplinary team (MDT). They also use PHC service delivery models to manage people with disabilities (PWDs). Occupational therapists in PHC have a strong perception of their relevance in the PHC reengineering streams, despite the numerous barriers and few facilitators to the integration of occupational therapy services in the PHC reengineering streams of the NHI.Conclusion: The perception of the study participants is that occupational therapy service integration in the PHC reengineering streams will lead to improved healthcare. However, they are also of the opinion that integration will not happen without advocacy from occupational therapists or occupational therapy being adequately supported in PHC.✥ Anthony Jejelaye -Postgraduate student -conceptualisation and completion of project and article manuscript. ✥ Lebogang Maseko -supervisor of MSc project -helped with the conceptualisation and guidance for completion of project. ✥ Denise Franzsen -supervisor of MSc project -helped with the conceptualisation and guidance for completion of project.

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Section: Literature Review Rehabilitation At a Primary Health Care Lementioning

confidence: 99%

Occupational therapy services and perception of integration of these at primary healthcare level in South Africa

Jejelaye¹,

Maseko²,

Franzsen³

2019

S. Afr. j. occup. ther.

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“…durch eine höhere psychische Krankheitslast und schlechtere psychische Gesundheit von Menschen mit Behinderung erklärt werden [19]. 51 (1,27-1,81)* 1,44 (1,18-1,76)* Besuch Facharzt/-ärztin (n = 23.150) 1,75 (1,54-1,98)* 1,32 (1,14-1,52 56 (1,40-1,73)* 1,46 (1,29-1,66)* Zahnmedizinische Untersuchung (n = 23.180) 1 ,28 (1,13-1,44)* 1,57 (1,33-1,86 [5,10,33], weite und z. T. problematische Wege zu Gesundheitsdienstleistern [17,30] sowie Schwierigkeiten bei der Finanzierung von Untersuchungen bzw. Behandlungen und Medikamenten [1,30] haben.…”

Section: Introductionunclassified

Inanspruchnahme und wahrgenommene Barrieren des Gesundheitswesens bei Menschen mit Behinderung in Deutschland: Ergebnisse des GEDA 2014/2015-EHIS-Survey

Wetzel

Rathmann

2020

Präv Gesundheitsf

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Zusammenfassung Hintergrund Menschen mit Behinderung sind in der gesundheitlichen Versorgung benachteiligt. Eine bedarfsgerechte Gesundheitsversorgung verlangt einen gleichberechtigten Zugang zum Gesundheitswesen ohne Barrieren. Erstmals werden Inanspruchnahme und wahrgenommene Barrieren des Gesundheitswesens bei Menschen mit und ohne Behinderung, differenziert nach dem Grad der Behinderung (GdB) mittels repräsentativer Daten für Deutschland ausgewertet. Fragestellung Gibt es Unterschiede in der Inanspruchnahme und den wahrgenommenen Barrieren des Gesundheitswesens von Menschen mit im Vergleich zu Menschen ohne Behinderung? Material und Methode Datenbasis bildet der Survey „Gesundheit in Deutschland Aktuell 2014/2015“. Die Stichprobe umfasst 23.481 Personen mit und ohne Behinderung, wovon 1295 Personen (5,5 %) einen GdB <50 und 2395 Personen (10,2 %) einen GdB ≥50 aufweisen. Uni-, bi- und multivariate Analysen wurden für die abhängigen Variablen Besuch von Haus- und Fachärzt*innen, ambulante und stationäre Krankenhausaufenthalte und wahrgenommene Barrieren (u. a. Wartezeit auf einen Termin, Entfernung, Nicht-Bezahlbarkeit von Untersuchungen) vorgenommen. Ergebnisse Menschen mit Behinderung haben höhere Chancen für eine Inanspruchnahme des Gesundheitswesens als Menschen ohne Behinderung. Dabei zeigt sich ein behinderungsspezifischer Gradient nach dem GdB. Menschen mit Behinderung nehmen außerdem häufiger Barrieren im Gesundheitswesen wahr als Menschen ohne Behinderung z. B. für Untersuchungsverzögerungen aufgrund einer weiten Entfernung und weil sie sich ärztliche Untersuchungen nicht leisten können. Schlussfolgerungen Die Ergebnisse verdeutlichen den in der Behindertenrechtskonvention der Vereinten Nationen geforderten Abbau von Barrieren im Gesundheitswesen für Menschen mit Behinderung. Studien sind aufgefordert zielgruppenadäquate Bedarfe und Barrieren in der Gesundheitsversorgung, differenziert nach dem GdB, zu erfassen.

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“…accessing health care (8)(9)(10)(11)(12)(13)(14). These barriers are attributed largely to several weaknesses in the health systems as well as individual factors of people with disabilities.…”

mentioning

confidence: 99%

In search of universal health coverage – highlighting the accessibility of health care to students with disabilities in Ghana: a qualitative study

Abodey

Vanderpuye

Mensah

et al. 2020

Preprint

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Background: Accessibility of health care to students with disabilities is a global concern. This is no less important in Ghana, however, to date, no study has been undertaken regarding access to health care to students with disabilities. This study, therefore, aims to explore the accessibility of health care to students with disabilities, in the quest of achieving universal health coverage in Ghana. Methods:Qualitative methods, involving in-depth interviews were employed to collect data from 54 participants (29 students with disabilities, 17 health workers and 8 school mothers), selected through purposive sampling. Thematic analysis was used to analyze the data. Results : The study identified three themes -accessibility, adequacy, and affordability. The study findings highlighted that universal health coverage for students with disabilities has not been achieved due to barriers in accessing health care. The barriers faced by students with disabilities were unfriendly physical environments, structures, equipment, limited support services and poor health insurance policy to finance health care. Conclusion : The study concludes that the government should prioritize disability-related issues in health policy formulation, implementation and monitoring. The current provisions and requirements in the disability act should be prioritized, enforced and monitored to ensure adequate inclusion of disability issues in health services. Further, the current exemption policy under the National Health Insurance Scheme should be revised to adequately address the needs of people with disabilities.

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Access to health care for persons with disabilities in rural South Africa

Cited by 106 publications

References 45 publications

Occupational therapy services and perception of integration of these at primary healthcare level in South Africa

Occupational therapy services and perception of integration of these at primary healthcare level in South Africa

Inanspruchnahme und wahrgenommene Barrieren des Gesundheitswesens bei Menschen mit Behinderung in Deutschland: Ergebnisse des GEDA 2014/2015-EHIS-Survey

In search of universal health coverage – highlighting the accessibility of health care to students with disabilities in Ghana: a qualitative study

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