Health-worker education for disability inclusion in health

Azizatunnisa, Luthfi; Rotenberg, Sara; Shakespeare, Tom; Singh, Satendra; Smythe, Tracey

doi:10.1016/s0140-6736(23)02707-1

Cited by 10 publications

(4 citation statements)

References 16 publications

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“…Developing a comprehensive training programme for healthcare workers on disability is an important step in addressing barriers to healthcare access for people with disabilities [ 3 ]. We used the Medical Research Council approach to develop the training material [ 17 ], considering practical solutions to improve the knowledge and skills of healthcare workers on disability.…”

Section: Discussionmentioning

confidence: 99%

“…Approximately 16% of the world’s population, or 1.3 billion people, live with a disability, and the majority live in low and middle income countries (LMIC) [ 1 ]. Access to inclusive healthcare services is vital for promoting health equity and social inclusion for all [ 2 , 3 ]. However, healthcare workers’ lack of knowledge, skills, and attitudes towards disability remains a significant barrier to achieving this goal [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…This requires training to ensure that healthcare staff are aware of disabilities, possess relevant skills, and maintain positive attitudes, enabling them to make appropriate linkages to other necessary care. Efforts to integrate disability-related education and training into healthcare curricula and continuing education programs are crucial in addressing this issue [ 1 – 3 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

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Co-development of a training programme on disability for healthcare workers in Uganda

Smythe,

Ssemata,

Slivesteri

et al. 2024

BMC Health Serv Res

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Background Approximately 1.3 billion people worldwide face barriers in accessing inclusive healthcare due to disabilities, leading to worse health outcomes, particularly in low and middle-income countries (LMIC). However, there is a lack of training of healthcare workers about disability, both globally and in Uganda. Objectives To use mixed research methods to develop a comprehensive training program with standardisedelements for healthcare workers in Uganda, focusing on improving their knowledge, attitudes, and skills inproviding care for people with disabilities. Methods The Medical Research Council (MRC) approach was employed to guide the development of the training intervention. We conducted an umbrella review to gather relevant literature on disability training for healthcare workers. Interviews were conducted with international experts to gain insights and perspectives on the topic. Additionally, interviews were undertaken with people with disabilities and healthcare workers in Uganda to understand their experiences and needs. A participatory workshop was organised involving key stakeholders, to collaboratively design the training material based on the findings from these data sources. Results Eight review articles examined training programs for healthcare workers on disability. Training settings ranged from specialised clinical settings to non-clinical settings, and the duration and evaluation methods of the training varied widely. Lectures and didactic methods were commonly used, often combined with other approaches such as case studies and simulations. The impact of the training was assessed through healthcare worker reports on attitudes, knowledge, and self-efficacy. Interviews emphasised the importance of involving people with disabilities in the training and improving communication and understanding between healthcare providers and people with disabilities. Five themes for a training on disability for healthcare workers were generated through the workshop, including responsibilities and rights, communication, informed consent, accommodation, and referral and connection, which were used to guide the development of the curriculum, training materials and training approach. Conclusion This study presents a novel approach to develop a training program that aims to enhance healthcare services for people with disabilities in Uganda. The findings offer practical insights for the development of similar programs in LMICs. The effectiveness of the training program will be evaluated through a pilot test, and policy support is crucial for its successful implementation at scale.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Co-development of a training programme on disability for healthcare workers in Uganda

Smythe,

Ssemata,

Slivesteri

et al. 2024

BMC Health Serv Res

Self Cite

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“…Consequently, health-care workers require training on disability so that they have the right knowledge, skills and attitudes to provide high quality services to people with disabilities. 70 , 73 The curriculum should include training on: awareness of rights and needs of women with disabilities with respect to cervical cancer screening, the ability to use reasonable accommodations, alternative communication options and approaches to taking consent for people with intellectual impairments. Information to aid stigma reduction should also be included, such as challenging assumptions that women with disabilities are asexual and therefore do not require cervical cancer screening.…”

Section: Resultsmentioning

confidence: 99%

Principles for Service Delivery: Best Practices for Cervical Screening for Women with Disabilities

Kuper,

Andiwijaya,

Rotenberg

et al. 2024

IJWH

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Background Cervical cancer screening is an important public health priority, yet many marginalized groups are not reached by existing programs. The nearly 700 million women with disabilities globally face substantial barriers in accessing cervical cancer screening and have lower coverage, yet there is limited evidence on what would support enhanced uptake among this population. Methods We updated a systematic review to estimate the disparity in screening uptake for women with disabilities. We conducted a scoping review to understand key barriers and the inclusion of disability in existing screening policies and possible solutions to improve screening uptakes amongst women with disabilities. We then formulated key principles for improved service delivery for this group, targeted predominantly at clinicians. Results Our updated review identified an additional five new studies, and confirmed that women with disabilities were less likely to be screened for cervical cancer (RR=0.65, 0.50–0.84). Disability-specific barriers to accessing screening pertained to: (1) knowledge and autonomy; (2) logistics; and (3) stigma and fear. Few guidelines included specific considerations for women with disabilities. Our scoping review showed that improving access to care must focus on improving (1) autonomy, awareness, and affordability; (2) human resources; and (3) health facility accessibility. Conclusion Screening programmes and health providers must ensure women with disabilities are included in cervical cancer screening programmes and thereby help to achieve their right to health and eliminate cervical cancer as a public health issue.

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A dearth of disability‐related competencies in Accreditation Council for Graduate Medical Education's Milestones 2.0

Houtrow,

Hurwitz

2024

PM&R

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BackgroundDespite the high prevalence of disability and the frequency with which people with disabilities encounter the health care system, physicians report inadequate knowledge regarding caring for their patients with disabilities.ObjectiveTo determine the number and type of disability‐related competencies in the Accreditation Council for Graduate Medical Education's Milestones 2.0.DesignCross‐sectional analysis of publicly available data to identify, via key word search, the presence of disability‐related competencies using disability‐related terms derived from the World Health Organization's International Classification of Functioning Disability and Health.SettingAccreditation Council for Graduate Medical Education's Milestones 2.0.ParticipantsN/AInterventionsN/AMain Outcome MeasurePresence of disability‐related competencies.ResultsOver one‐third (37.5%) of specialties had zero disability‐related competencies. Nineteen (59.4%) included an Interpersonal and Communication Skills Milestone that mentions disability as a potential barrier to communication. No specialties had Systems‐Based Practice or Practice‐Based Learning and Improvement disability‐related competencies. Physical medicine and rehabilitation (PM&R) had six disability‐related competencies, preventive medicine occupational and environmental medicine had three, and otolaryngology and transition year each had two.ConclusionsA minority of medical and surgical specialties had disability‐related competencies outside of the Interpersonal and Communication domain. With the rising prevalence of disability and the lack of physicians with expertise in the care of people with disability, the time is now to integrate disability competencies into residencies, especially for the primary care specialties.

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Health-worker education for disability inclusion in health

Cited by 10 publications

References 16 publications

Co-development of a training programme on disability for healthcare workers in Uganda

Co-development of a training programme on disability for healthcare workers in Uganda

Principles for Service Delivery: Best Practices for Cervical Screening for Women with Disabilities

A dearth of disability‐related competencies in Accreditation Council for Graduate Medical Education's Milestones 2.0

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