People with Disabilities and COVID-19 in the state of Espírito Santo, Brazil: between invisibility and lack of Public Policies

Melo, Douglas Christian Ferrari de; Siqueira, Priscila Carminati; Maciel, Ethel Leonor Nóia; Delcarro, Jessica Cristina Silva; Robaina, Igor Martins Medeiros; Jabor, Pablo Medeiros; Gonçalves, Etereldes; Zandonade, Eliana

doi:10.1590/1413-812320222711.08232022en

Cited by 3 publications

(2 citation statements)

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“…Inadequate information on health inequalities has been identified as a distinct gap in strengthening inclusion and equity in COVID-19 responses. [6] The scanty available evidence globally shows lower COVID-19 vaccination rates compared to those without disability [7] amidst higher risk of severe illness and premature mortality from COVID-19 [8].…”

Section: Introductionmentioning

confidence: 99%

Behavioural and Social Predictors of COVID-19 Vaccine Uptake among Persons with Disabilities in Kenya

Josphat,

Moraro,

Omogi

et al. 2023

Preprint

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The uptake of the COVID-19 vaccine by persons with disabilities remains largely unknown in low-and middle-income countries. This evidence gap necessitates disability-focused research to inform improvements in access and inclusion in the last mile of COVID-19 vaccination programs and to support future programs for other vaccine-preventable diseases. We aimed to identify behavioural and social predictors of COVID-19 uptake among persons with disabilities in Kenya. This was a convergent parallel mixed method study that involved questionnaires (792), key informants interviews, and focus group discussions among persons with disabilities and key stakeholders (government actors and professional associations). Data were analysed using STATA statistical analysis software (version 14). Chi-square (X2) and Fisher’s exact tests were used to test for differences in categorical variables; multivariate regression analysis was employed to ascertain the factors that influence uptake of COVID-19 among persons with disabilities (PWDs) in Kenya. Approximately 59% of persons with disabilities reported to be fully vaccinated, with significant disparities noted among those with cognition (34.2%) and self-care (36.6%) impairments. Confidence in vaccine benefits (Adjusted odds ration [OR]; 11.3, 95% CI; 5.2-24.2), health worker recommendation (OR; 2.6, 95% CI; 1.8-3.7), employment (OR; 2.1, 95% CI; 1.4-3.1), perceived risk (OR; 2.0, 95% CI; 1.3-3.1), age and area of residence were statistically significant predictors of vaccine uptake among PWDs. The primary reasons for low uptake included perceived negative vaccine effects and lack of adequate information. No association was found between having a primary caregiver and/or assistive device, with COVID-19 vaccine uptake. Subsequent vaccination deployments should map and reach PWDs through relevant institutions of PWDs, and localized vaccination campaigns. Related communication strategies should leverage on behaviour change techniques that inspire confidence in vaccines, and on the credibility and trust in health workers to improve vaccine uptake.

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Section: Introductionmentioning

confidence: 99%

Behavioural and Social Predictors of COVID-19 Vaccine Uptake among Persons with Disabilities in Kenya

Josphat,

Moraro,

Omogi

et al. 2023

Preprint

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“…No Brasil, dados como a presença de deficiência não são obrigatórias nas notificações de casos suspeitos e confirmados, ou de mortes por Covid-19 em todos os estados, o que gera uma enorme dificuldade de produzir conhecimento a este respeito. Pesquisadores do estado do Espírito Santo, puderam verificar que a letalidade por Covid-19 também foi maior para PCD (4,9%) do que para pessoas sem deficiência (3%) no período estudado, e alertam para a invisibilidade dessa população na adoção de políticas públicas específicas (54) .…”

Section: Iniquidades Sociais Durante a Pandemiaunclassified

A pandemia de Covid-19 e os serviços de reabilitação para pessoas com deficiência no SUS

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A meu pai, com saudades, admiração e profunda gratidão por seu esforço e dedicação incansáveis para que eu pudesse chegar até aqui. AGRADECIMENTOSÀ Prof.ª Dr.ª Aylene por ter conduzido este processo com tamanha grandeza, sensibilidade e generosidade.Ao Paulo por ser uma referência para a pesquisa e para minha vida.Aos amigos e companheiros de luta no SUS pelo incentivo a acreditar que o progresso é possível.À minha família, mamãe, Amanda, Cinthia e Gabriel pelo cuidado, companhia e paciência durante toda a caminhada. AoConselho Nacional de Desenvolvimento Científico e Tecnológico, Ministério da Ciência, Tecnologia e Inovação e do Ministério da Saúde pelo apoio financeiro para a realização a pesquisa. "Desafios da implementação da Rede de Cuidados à Pessoa com Deficiência em diferentes contextos regionais: abordagem multidimensional e multiescalar", por meio da chamada MS-SCTIE-DECIT/CNPQ Nº35/2018. À Coordenação de Aperfeiçoamento de Pessoal de Nível Superior pelo apoio ao programa de Pós-Graduação. RESUMO Introdução -A pandemia de Covid-19 trouxe impactos significativos para a rede de serviços de saúde e afetou, sobremaneira, os cuidados em saúde para pessoas com deficiência (PCD). Objetivo -Analisar o impacto da pandemia no funcionamento dos Centros Especializados em Reabilitação (CER) no SUS e os fluxos assistenciais percorridos por usuários com Síndrome Pós-Covid19. Método -O estudo foi composto por duas partes complementares. A primeira, focada nos efeitos da pandemia para cuidados às PCD, utilizou método misto composto pela análise da variação da produção ambulatorial dos CER, entre março/2019 a dezembro/2021, cotejando tais resultados com as percepções de gestores e profissionais de reabilitação de CER aferidas por websurvey. Foram calculadas as médias mensais de 247 procedimentos, para o ano anterior à pandemia, primeiro e segundo anos de pandemia. No websurvey foram investigados: funcionamento e organização dos serviços; reabilitação Pós-Covid-19; ações de apoio aos usuários e profissionais; estratégias e desafios vivenciados. A segunda parte analisou itinerários terapêuticos de residentes no município de São Paulo, com necessidade de reabilitação pós-Covid-19, atendidos por um CER, até a saturação de conteúdo nas narrativas. Os relatos foram transcritos e analisados segundo as dimensões: do adoecimento ao diagnóstico; internação hospitalar; cuidados após alta e reabilitação, com identificação de barreiras, facilitadores e estratégias para a garantia do acesso e da continuidade do cuidado. Resultados -Verificou-se impacto significativo sobre a produção ambulatorial dos CER brasileiros, com redução de 33,3% do total de procedimentos registrados entre o primeiro ano de pandemia e o ano anterior, com maior prejuízo para atividades em grupo, terapias visuais e visitas domiciliares, e com aumento de 104,1% de procedimentos de Fisioterapia Cardiorrespiratória. No websurvey, foram relatadas a descontinuidade da assistência e a necessidade de modificações estruturais e organizacionais como: reorganização de aten...

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Behavioral and social predictors of COVID-19 vaccine uptake among persons with disabilities in Kenya

Muchangi,

Moraro,

Omogi

et al. 2024

Front. Public Health

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Access and uptake of COVID-19 vaccine by persons with disabilities remains largely unknown in low-and middle-income countries, despite the unique barriers they face, their special vulnerabilities and higher risk to severe outcomes. We aimed to identify behavioral and social predictors of COVID-19 uptake among persons with disability in Kenya. A convergent parallel mixed method study design was conducted among 792 persons with disability in four regions (counties) in Kenya. Purposive sampling was used to identify the respondents from the National Council for Persons with Disabilities Registration database. Quantitative data were analyzed using STATA statistical analysis software (version 14). Chi-square (X2) and Fisher's exact tests were used to test for differences in categorical variables; and multivariate regression analysis done to ascertain the factors that influence the uptake of COVID-19 among persons with disabilities in Kenya. Qualitative data from 7 Focus Group Discussions and 4 Key Informant Interviews were transcribed and themes developed using the Behavioral and Social Drivers of vaccination framework by the World Health Organization. Approximately 59% of persons with disabilities reported to be fully vaccinated with significant disparities noted among those with cognition (34.2%) and self-care (36.6%) impairments. Key predictors of vaccine uptake included confidence in vaccine benefits (Odds ratio [OR]; 11.3, 95% CI[5.2–24.2]), health worker recommendation (OR; 2.6 [1.8–3.7]), employment (OR; 2.1 [1.4–3.1]), perceived risk (OR; 2.0 [1.3–3.1]), age 18–24 years (OR; 0.18 [0.09–0.36]), and rural area of residence (OR; 0.48 [0.29–0.79]). The primary reasons for low uptake included perceived negative vaccine effects and lack of adequate information. Qualitative findings revealed unique motivations for vaccination among persons with disabilities (PWDs), including safeguarding against risks from assistive devices and the influence of political leaders. Barriers included perceived vaccine effects, transportation challenges, and limited access to trusted information, highlighting the need for targeted sensitization, improved healthcare worker engagement, and collaboration with PWD organizations. Subsequent vaccination deployments should map and reach people in all disability domains through relevant institutions of PWDs and localized vaccination campaigns. Related communication strategies should leverage the credibility and trust in health workers and behavior change techniques that inspire confidence in vaccines to improve vaccine uptake.

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People with Disabilities and COVID-19 in the state of Espírito Santo, Brazil: between invisibility and lack of Public Policies

Cited by 3 publications

References 11 publications

Behavioural and Social Predictors of COVID-19 Vaccine Uptake among Persons with Disabilities in Kenya

Behavioural and Social Predictors of COVID-19 Vaccine Uptake among Persons with Disabilities in Kenya

A pandemia de Covid-19 e os serviços de reabilitação para pessoas com deficiência no SUS

Behavioral and social predictors of COVID-19 vaccine uptake among persons with disabilities in Kenya

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