Barriers to the Implementation of the Health and Rehabilitation Articles of the United Nations Convention on the Rights of Persons with Disabilities in South Africa

Abstract

Background: The United Nations (UN) Convention on the Rights of Persons with Disabilities (CRPD) is a milestone in the recognition of the human rights of persons with disabilities, including the right to health and rehabilitation. South Africa has signed and ratified the CRPD but still has a long way to go in reforming policies and systems in order to be in compliance with the convention. This paper seeks to fill a gap in the literature by exploring what the barriers to the implementation of the health and rehabilitation articles of the CRPD are, as identified by representatives of the disability community. Methods: This investigation used a qualitative, exploratory methodology. 10 semi-structured interviews of a purposive sample of representatives of disabled persons organizations (DPOs), non-governmental organizations (NGOs), and service providers in South Africa were conducted. Participants were drawn from urban, peri-urban, and rural settings in order to reflect diverse perspectives within South Africa. Data was analysed using a multi-stage coding process to establish the main categories and relationships between them. Results: Six main categories of barriers to the implementation of the health and rehabilitation articles of the CRPD were identified. Attitude barriers including stigma and negative assumptions about persons with disabilities were seen as an underlying cause and influence on all of the other categories; which included political, financial, health systems, physical, and communication barriers. Conclusion: The findings of this study have important implications for strategies and actions to implement the CRPD. Given the centrality of attitudinal barriers, greater sensitization around the area of disability is needed. Furthermore, disability should be better integrated and mainstreamed into more general initiatives to develop the health system and improve the lives of persons living in poverty in South Africa.

Prioritizing barriers and solutions to improve employment for persons with developmental disabilities

“…Despite this legislation, participants in this study identified potential discrimination against persons with developmental disabilities as the result of employer-based stigma, especially if an employer has past negative experience in employing a person with developmental disabilities. The same has been reported elsewhere where stigma and negative assumptions about persons with disabilities were seen as key barriers to implementation of rights-based policies such as the United Nations Convention on the Rights of Persons with Disabilities [90]. The fact that stigma was one of the top three barriers to participation or sustaining participation in the labour market for persons with developmental disabilities suggests that despite significant constitutional and institutional support and protection, persons with developmental disabilities continue to face extensive and deleterious discrimination.…”

Barriers to accessing primary healthcare services for people with disabilities in low and middle-income countries, a Meta-synthesis of qualitative studies

“…One belief system that appeared to discourage people with disabilities and their caregivers from seeking any healthcare services, including primary healthcare, was the belief that disability is related to or caused by higher powers outside of the person, such as religion or witchcraft [38][39][40][41][42]. This belief was often interpreted as the disability or any other symptoms experienced by an individual with a disability being inflicted by an external power, resulting in feelings that there was no point in seeking healthcare intervention and so treatments were only sought from traditional healers who might free the person of the condition [38][39][40][41][42]. While this belief was mostly expressed by people with disabilities and their caregivers in the studies, it is possible that it may have also been the driving force in many of the negative interactions experienced by people with disabilities and their caregivers from community members and healthcare stakeholders, who may have shared these beliefs.…”

Assistive technology policy: a position paper from the first global research, innovation, and education on assistive technology (GREAT) summit

“…Both documents put emphasis on the importance of available and affordable assistive technology for persons with disabilities [32]. Yet other research in South Africa suggests that the failure to effectively implement the health and rehabilitation articles of the UNCRPD is largely due not only to negative attitudes in society in general [32] but also from government officials and service providers towards people with disabilities [33] and a rights-based approach. This certainly incorporates most people who use assistive products.…”