BARRIERS AND FACILITATORS TO ACCESS TO HEALTH CARE FOR PERSONS WITH DISABILITIES, SOUTH AFRICA

N.A.R. Hussein El Kout¹, S.I. Pilusa¹, K. Masuku-Dlamini²

¹The University of the Witwatersrand, Physiotherapy, Johannesburg, South Africa, ²The University of the Witwatersrand, Speech Pathology and Audiology, Johannesburg, South Africa

Background: The prevalence of disability is increasing globally and in South Africa, increasing the burden of disease on an already strained healthcare system. The rights of persons with disabilities have not been actualised. A tool to actualise the rights of persons with disbaility is health policy. The Framework and Strategy for Disability and Rehabilitation (FSDR) aimed to guide rehabilitation and improve access to health care for persons with disabilties. Studies exploring the perception of policy stakeholders regarding barriers and facilitators to access to health care for persons with disabilities, are limited. This is necessary for strengthening rehabilitation policy and health care access.

Purpose: ​​​​To explore the factors affecting access to health care for persons with disabilities in the context of the FSDR.

Methods: The study was conducted in the Johannesburg metropolitan district. A qualitative single case study design comprising of semi-structured interviews with twelve participants was employed. Purposive and snowball sampling was used to select participants who were stakeholders involved in the processes of the FSDR. Inductive thematic analysis was done using MAXQDA qualitative data analysis software.

Results: Barriers to access include the lack of data, resource limitations, poor socio-economic conditions, absence of rehabilitation indicators and gaps in undergraduate training programmes in the field of rehabilitation. Facilitators to access include decentralisation of rehabilitation, disability advocacy, inter-disciplinary collaboration, and positive staff attitudes.

Conclusions:​Barriers to accessing health care for persons with disabilities far outweigh the facilitators, which leads to poorer health care outcomes for persons with disabilities. National monitoring and evaluation of the FSDR policy is required, prior to the formation of future disability policy to ensure policy challenges are addressed and access to health care is prioritised.

Implications: This study may inform future rehabilitation policy and be used as a tool for advocacy thus improving the actualisation of the rights of persons with disabilities. Clinical rehabilitation service provision may also be informed through this study and access to health care may be improved through the implementation of the recommendations. The study may also inform undergraduate training programmes in the field of rehabilitation, to improve awareness amongst students on the landscape of access to health care for persons with disabilities

Funding acknowledgements: National Research Foundation (NRF) of South Africa-MSc Physiotherapy
South African Society of Physiotherapy (SASP)-research grant

Keywords:
Access
Healthcare
Disability-policy

Topics:
Globalisation: health systems, policies & strategies
Health promotion & wellbeing/healthy ageing/physical activity
Disability & rehabilitation

Did this work require ethics approval? Yes

Institution: The University of The Witwatersrand

Committee: The Wits Human Research Ethics Committee (Medical)

Ethics number: M190438