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A disability-inclusive healthcare delivery system is the need of the hour

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For people with disabilities (PWDs) in developing countries, necessities like healthcare are out of reach for those who need it most. The harsh reality is that they face an uphill battle against poor health outcomes, discrimination, and exclusion from society’s most basic opportunities due to the impact of health inequities. The UN’s Sustainable Development Goal 3 ‘Good health and well-being for all’, aims to provide universal health coverage for PWDs to address these health inequities and improve their rights, health, and economic participation.

In India, the 2011 census reported that 2.21% of the population had a disability. That number has likely grown in the past decade. While India has made strides in including PWDs in government health schemes and programs, such as Ayushman Bharat Yojana, ADIP and Nirmaya Health Insurance, there are still significant challenges and gaps in the healthcare system in terms of disability inclusivity. Living in urban or rural areas also influence access to care due to their distinctive characteristics of resources, affordability and accessibility. People with disabilities face different sets of challenges in both contexts and hence need different approaches and practices for the inclusion and improvement of living conditions in urban and rural areas.

While accessibility upgrades are still needed for many healthcare facilities and services, there is also a need to understand the specific need for healthcare due to disability conditions, which includes specific health services related to disability conditions and comorbidity. Further, many healthcare workers lack the training and knowledge they need to provide appropriate and respectful care for PWDs. Thus, achieving disability inclusivity in healthcare requires developing and implementing innovative models so that PWDs are not deprived of care due to geographical, physical, or financial barriers.


Tailored approaches to address unique needs

Utilizing advancements in technology can enhance healthcare accessibility. Digital technologies such as electronic health records (EHRs) can be scaled to automate administrative tasks and data collection thereby streamlining management. Additionally, access through telehealth is a new-age delivery model which gained popularity during COVID.

Community-based rehabilitation model can be more accessible and culturally sensitive to PWDs, especially in rural or remote areas, as it provides care and support within the community.

Community-based organisations, volunteers, and traditional healers play a crucial role in making this possible. Since deinstitutionalisation is crucial for the progress of PWDs’ healthcare, person-centred, rights-based healthcare services and support within the community are more suitable alternatives.

Another innovative model of healthcare delivery that can help alleviate health disparities for vulnerable populations in rural and remote areas is the Mobile Medical Unit (MMU). This includes services like availability of free medicines, diagnostic tests, counselling and preventive services like periodic testing of drinking water at the point of usage etc. These services also include home visits for elderly and Persons with Disabilities (PwDs) and referral to tertiary care centres for critical patients. The MMUs work closely with public health officials at state, district and block level, as well as with the local panchayats ensuring that the vans and their services reach out to the truly underserved population of the country.

These innovative models coupled with strengthened government systems can greatly improve the accessibility, efficiency, and cost-effectiveness of healthcare. However, these models need to be part of a comprehensive and coordinated approach that addresses physical, communication, policy and attitudinal barriers. This will ensure accessibility and affordability, reduce stigma and discrimination and establish a proper channel for information dissemination.



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Autor: Shewata Rawat   Quelle: The Times of India (10.03.2023; GI-FH)
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