BARRIERS TO HEALTHCARE ACCESS OF PERSONS WITH DISABILITY IN LOW-INCOME COUNTRIES, A SYSTEMATIC REVIEW

¹University of the Sunshine Coast, Public Health, Maroochydore, Queensland, Australia

Background: About 15% of the world population are people living with one or more disabilities. This prevalence is higher, up to 20%, in developing countries. Many scholars alarm on the poor level of health among Persons With Disabilities (PWDs). They describe the health of PWDs as having a thinner or narrower margin. They argue that PWDs need more inpatient and outpatient services than the general population. Most of PWDs have more risk of developing secondary condition, co-morbid conditions, greater vulnerability to age-related conditions, and greater rates of health risk behaviors, exposition to violence, unintentional injuries, and premature deaths in comparison to the general population. However, PWDs face many challenges regarding healthcare access.

Purpose: This systematic review explores barriers for PWDs to access healthcare services in low-income countries.

Methods: Peer-review articles were systematically searched from three databases Scopus, Infomed, and Pubmed, using a defined equation. Each selected article underwent two stages of article assessment: the skimming stage against inclusion and exclusion criteria, and the critical analysis stage using a framework adopted from the Schema for Evaluating Evidence on Public Health Interventions of National Public Health Partnership, version 4.

Results: Fifteen articles were obtained. All of them are original studies and were conducted in low-income countries. Divided by types, the 15 studies are: 8 cross-sectional studies, 4 qualitative studies, 2 case-controlled studies, and 1 pre- and post-evaluation study. Nine studies were done in Asia and the Middle Eastern countries, and the other 6 were conducted in Africa. Twelve of the 15 studies found that barriers to access healthcare services among PWDs are physical and financial barriers. Two-third (10) of the studies indicate that the barriers were created by poor quality of care; provider knowledge, attitude, and belief; consumers’ limited knowledge about accessible healthcare service, negative attitude toward and belief about PWDs; and socio-culture.

Conclusions: This systematic review suggests that barriers to accessing healthcare for PWDs are physical; financial; quality of care; provider knowledge, attitude, and belief; consumer knowledge; and socio-culture. The review suggests that physical and financial play the key role in all developing countries where the original studies have been conducted.

Implications: This study provides evidence about barriers to healthcare access among PWDs in low-resource countries, in particular Asia and Africa. Although studies retrieving for this review mostly limited to cross-sectional and narrative, its findings may be informative about barriers to healthcare access among PWDs. This information is more important for policy makers who are responsible for regulation and policy development or improvement, and donors and service providers to tailor funds and interventions. Furthermore, this review may also be informative for disability stakeholders for their awareness and educational interventions aiming to address healthcare access of PWDs in low-income countries.

Funding acknowledgements: This abstract development is supported by International Committee of the Red Cross

Keywords:
Disability
Healthcare
Access

Topics:
Service delivery/emerging roles
Disability & rehabilitation
Globalisation: health systems, policies & strategies

Did this work require ethics approval? No

Reason: This systematic literature review was a desk study and therefore did not require an ethic approval.