Factors affecting access to primary health care services for persons with disabilities in rural areas: a “best-fit” framework synthesis

Global Health Research and Policy, Год журнала: 2018, Номер 3(1)

Опубликована: Дек. 1, 2018

Access to primary health care (PHC) is a fundamental human right and central in the performance of systems, however persons with disabilities (PWDs) generally experience greater barriers accessing PHC than general population. These problems are further exacerbated for those rural areas. Understanding access PWDs particularly important as such knowledge can inform policies, clinical practice future research settings.We conducted synthesis published literature explore factors affecting areas globally. Using an adapted keyword search string we searched five databases (CINAHL, EMBASE, Global Health, Medline Web Science), key journals reference lists included articles. We imported articles into NVivo deductive (framework) analysis by charting data framework. subsequently inductive (thematic) analysis.We identified 36 studies that met our inclusion criteria. A majority (n = 26) were low-and middle-income countries. found unable due obstacles including interplay four major factors; availability, acceptability, geography affordability. In particular, limited availability facilities services perceived low quality meant need frequently had travel care. The barrier geographic distance was worsened transportation problems. also observed where available most people could not afford cost.Our noted modifying framework incorporate relationships among might help better conceptualize challenges opportunities settings. made recommendations policy development, consideration lead more equitable Importantly, there policies aim address consider all dimensions their interactions. terms practice, review highlights provide in-service training providers on how enhance communication skills PWDs. Future should focus exploring geographical contexts different perspectives respond

Язык: Английский

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Exploring Barriers to Accessing Adolescents Sexual and Reproductive Health Services in South Ethiopia Regional State: A Phenomenological Study Using Levesque’s Framework

Adolescent Health Medicine and Therapeutics, Год журнала: 2024, Номер Volume 15, С. 45 - 61

Опубликована: Март 1, 2024

Evidence suggests that adolescents face multiple barriers to accessing Sexual and Reproductive Health (SRH) services. However, there remains a notable gap in the literature regarding nuanced interplay between supply-side demand-side barriers. Therefore, this study aimed examine SRH services Gamo Zone of South Ethiopia Regional State.

Язык: Английский

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Challenges in Accessing Health Care for People with Disability in the South Asian Context: A Review

International Journal of Environmental Research and Public Health, Год журнала: 2018, Номер 15(11), С. 2366 - 2366

Опубликована: Окт. 26, 2018

South Asia is a unique geopolitical region covering 3.4% of the world's surface area and supporting 25% population (1.75 billion). Available evidence from shows variable estimates magnitude disability. The projected depends on whether an impairment focus highlighted (approximately 1.6⁻2.1%) or functionality given precedence (3.6⁻15.6%). People with disability (PWD) face significant challenges to accessing health care in region. Studies show that adults reported four times higher incidence serious problem year's recall period. Evidence significantly rate (17.8%) hospitalization among PWD compared others (5%). Chronic conditions like diabetes were also higher. Women had more concerns reproductive issues. reveal not only did have load adverse outcomes but they faced barriers services.

Язык: Английский

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Disability-friendly healthcare at public health facilities in Bangladesh: a mixed-method study to explore the existing situation

BMC Health Services Research, Год журнала: 2022, Номер 22(1)

Опубликована: Сен. 20, 2022

Several strategies and policies are being implemented in Bangladesh to address the healthcare needs of people with disabilities, who comprise about 10% country's total population. However, these measures not adequate provide accessible or friendly disabilities. This study aimed explore disability-friendliness facilities, challenges disabilities terms access 1) information communication, 2) infrastructure, 3) providers' capacity Bangladesh.An explanatory sequential mixed-method was conducted, including a cross-sectional survey followed by structured-interview managers, qualitative interviews among their caregivers, providers (HCPs), policymakers, community leaders. Data were collected from 150 public (primary-to-tertiary) facilities 300 16 districts across between January-December 2019. An observational checklist structured questionnaires used assess situation literature-guided guidelines for interviews. During analysis, quantified through scoring system, thematic analysis data performed identify implementing disability-friendly (DFHC).The score providing DFHC low all four objectives facilities. The highest (mean percentage) observed infrastructure domain: 29.3 ± 20.5, communication: 18.2 4.8, information: 14.6 6.22, lowest (0.93 7.1) HCPs DFHC. Mean percentage scores 13 points low, extremely found areas such as elevators (5.6 5.0), ticket counters (7.3 17.7) toilets (10.6 9.3). Furthermore, 59.1% expressed dissatisfaction regarding communication. majority (98.2%) recommended that training can improve situation.This revealed most health disability-friendly. Findings inform development national policy implementation guidelines.

Язык: Английский

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Exploring Barriers to Accessing Sexual and Reproductive Health Services among Adolescents and Young People with Physical Disabilities in South Africa

International Journal of Environmental Research and Public Health, Год журнала: 2024, Номер 21(2), С. 199 - 199

Опубликована: Фев. 8, 2024

Despite South Africa having a progressive and liberal sexual reproductive health (SRH) policy framework, adolescents young people with disabilities (AYPWDs) are less likely to receive healthcare, being consequently predisposed long-term detrimental impact on their health. Our study explored the barriers accessing services (SRHSs) in clinics among AYPWDs Mpumalanga, Africa. We conducted descriptive qualitative twenty-seven four focus group discussions using semi-structured interviews, audiotaped transcribed verbatim, then applied thematic analysis of data. Employing socio-ecological model, findings show poor socioeconomic status, lack information SRH, attitudes as at individual level, hindering from SRHSs clinics. also faced difficulties talk about SRH parents, support seek SRHSs, improper care family/parents, negative friends, interpersonal level. They further expressed community/societal level non-disabled community members infrastructure for wheelchair use. At organization access was negatively affected by HCWs’ maltreatment, described forms attitudes, judgmental verbal abuse, discrimination, bullying. Furthermore, communication HCWs, well violating confidentiality misconceived ideas sexuality. Intensified efforts strengthen public strategies needed improve Africa, enhancing proficiency skills HCWs educating AYPWDs, SRH.

Язык: Английский

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‘I’m not ok, we are not ok’: an exploration into the embodied precarity experienced by disabled people and their family members living in rural South Africa during the COVID-19 pandemic

Medical Humanities, Год журнала: 2025, Номер unknown, С. medhum - 013026

Опубликована: Янв. 6, 2025

Research suggests that the impact of COVID-19 pandemic on disabled people was magnified compared with non-disabled people; however, little is known about experiences living in rural areas, particularly those Global South. Disabled areas experience significant challenges related to poverty, food insecurity and access information healthcare. Data were collected Nkomazi East Municipality Mpumalanga, South Africa. Interviews two key informants conducted English. Eight semistructured interviews Siswati disabilities. Five family members disabilities also interviewed. All data transcribed translated into English, then analysed using inductive thematic analysis interpreted through lens corporeal vulnerability. Findings revealed increased isolation, stigma, discrimination financial during pandemic, giving rise a sense embodied precarity. Access healthcare influenced by presence gatekeepers informal triage systems. Experiences compounded supply challenges, limited public transport complexities trying maintain social distancing, intensifying inequality. suggest oppression because communal threat survival. They highlight need for awareness, support policy reform response imposed specific focus basic human rights, including information, nutrition ensuring dignity all community members. Additional efforts are needed planning future crises ensure responses authentically disability inclusive.

Язык: Английский

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Healthcare Access for People with Disabilities in LMICs

Опубликована: Янв. 1, 2025

Язык: Английский

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Assessment of the feasibility of a community-based mental health training programme for persons with disabilities by non-specialists from different stakeholders’ perspectives in Bangladesh

BMC Health Services Research, Год журнала: 2024, Номер 24(1)

Опубликована: Март 4, 2024

Abstract Introduction Bangladesh is a developing country where 11% of the population has at least one disability, but no community-level mental health service available. There limited evidence burden issues and health-seeking behaviour among this population. This study assessed feasibility training intervention for persons with disabilities, peer support providers provided community-based disability-inclusive services. Methods Four stakeholder groups participated in qualitative study: responders (trained disabilities), trainers, representatives organisations disabilities disability-specific organisations, officials international national non-governmental organisations. Two types interviews were used to collect data, thematic analysis techniques utilised. Result Stakeholders perceived responder programme as acceptable develop themselves providers, potential benefits including increased literacy, ensuring accessible services, improving well-being disabilities. Potential challenges included receiving delivering Increased duration, more fieldwork, supervision opportunities, refresher recommended mitigate challenges. Financial formal community recognition deemed necessary delivery. Conclusion The was feasible ensure services build workforce screen conditions, provide appropriate referrals. A multi-sectoral collaboration government institutions policy advocates expand mainstream healthcare system.

Язык: Английский

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Empowering self-help groups for caregivers of children with disabilities in Kilifi, Kenya: Impacts and their underlying mechanisms

PLoS ONE, Год журнала: 2020, Номер 15(3), С. e0229851 - e0229851

Опубликована: Март 9, 2020

Bringing up a child with disabilities in low-income setting is challenged by inadequate resources, limited psycho-social support and poverty. Not surprisingly, many caregivers experience fatigue, distress isolation. To address investigate these issues, action was taken to set twenty self-help groups focusing on caregiver empowerment. A realist evaluation design adopted evaluate impacts associated the process identify mechanisms determining outcomes. Monthly monitoring visits were conducted during ten-month set-up period, at end of which eleven active remained, nine having dissolved due disputes, corruption extreme environmental conditions. facilitated intervention delivered (N = 154) over six-month period. The members guided review discuss topics such as economic empowerment, personal situation, peer support, community inclusion, access health education. Evaluation employed mixed methods using questionnaires (n 75) semi-structured interviews 36) pre- post-intervention. At baseline, burden caregiving characterised aloneness, challenges, stigma discrimination. Post-intervention, agency defined togetherness, capacity-building, acceptance well-being. Significant perceptions included increased social reduced severity child's disability decreased effects extrinsic factors affecting caregiver's role. Mechanisms 'handling goods money' 'social ties support' appeared underpin Caregiver empowerment newly developed skills, connectedness resource mobilisation. Documentation group processes contributes evidence community-based inclusive development.

Язык: Английский

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Understanding the role of lady health workers in improving access to eye health services in rural Pakistan – findings from a qualitative study

Archives of Public Health, Год журнала: 2021, Номер 79(1)

Опубликована: Фев. 17, 2021

Abstract Background In 1994, the Lady Health Workers (LHWs) Programme was established in Pakistan to increase access essential primary care services and support health systems at household community levels. Khyber Pakhtunkhwa (KPK) province northern Pakistan, eye is among many unmet needs that LHWs were trained address, including screening referral of people with conditions facilities. However, despite an referrals by LHWs, compliance KPK has been very low. We explored role patient barriers referrals. Methods Qualitative methodology adopted. Between April June 2019, we conducted eight focus group discussions nine in-depth interviews 73 participants patients, their supervisors, district managers other stakeholders. Data analysed thematically using NVivo software version 12. Results have a broad understanding basic are responsible for wide range activities level. felt training had equipped them skills identify refer patients. they reported hampered when referred patients reached hospitals, where disorganised poor quality discouraged uptake this negative impact on credibility trust respect received from community, which, coupled low awareness, influenced patients’ decisions about whether comply referral. There lack provided public sector hospitals. Poverty, deep-rooted gender inequities transportation main drivers non-adherence Conclusions study shown well received. alone not enough does result improved specialist if parts system strengthened. Pathways should be agreed explicitly communicated both providers

Язык: Английский

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