Human Rights and Programming for Persons with Disabilities:Special focus on Access to Health care services

 

10 – 14 November 2014Johannesburg, South Africa

ARASA Training of Trainers Workshop

Presented By: Phillimon Simwaba

Disability is everyone’s business

People with disabilities are not necessarily sick

People with disabilities are not asexual

Access means more than ramps

People with disabilities want the same things in life that

everyone wants

For people with disabilities, prejudice can be the biggest

barrier

KEY MESSAGES ABOUT PEOPLE WITH DISABILITIES AND THE RIGHT TO HEALTH CARE

KEY MESSAGES ABOUT PEOPLE WITH DISABILITIES AND THE RIGHT TO HEALTH CARE

Everywhere and always, people with disabilities are entitled to self-determination, privacy, respect and dignity

It is best and usually easy to mainstream health services that accommodate people with disabilities

People with disabilities are a crucial constituency in all programmes

Programmes best suit people with disabilities when people with disabilities help to design them: “Nothing about us without us” is a key principle

Health can be defined as “a state of physical, mental, and

social well being and not merely the absence of disease or infirmity”. Good health is a prerequisite for participation in a wide range of activities including education and employment

Article 25 of the United Nations Convention on the Rights of Persons with Disabilities(CRPD) reinforces the right of persons with disabilities to attain the highest standard of health care, without discrimination

DEFINITION OF HEALTH: UNCRPD

DISABILITY AND HEALTH People with disabilities face many barriers to good health;

Studies show that individuals with disabilities are more likely

than people without disabilities to report:

Having poorer overall health

Having less access to adequate health care

Engaging in risky health behaviors, including smoking and

physical inactivity

People with disabilities often are more susceptible to

preventable health problems that decrease their overall health

and quality of life. Secondary conditions such as pain, fatigue,

obesity, and depression can occur as a result of having a

disabling condition

KEY FACTS

Stereotypes about disability on the part of healthcare providers;

Health care provider misinformation, and lack of appropriately trained staff;

Limited health care facility accessibility and lack of examination equipment that can be used by people with varying disabilities;

Lack of sign language interpreters; andLack of materials in formats that are accessible to

people who are blind or have low vision

BARRIERS TO HEALTH CARE

People with disabilities encounter a range of barriers when they attempt to access health care including the following

Prohibitive costs: Affordability of health services and transportation are two main reasons why people with disabilities do not receive needed health care in low-income countries - 32-33% of non-disabled people are unable to afford health care compared to 51-53% of people with disabilities

Limited availability of services: The lack of appropriate services for people with disabilities is a significant barrier to health care

Physical barriers: Uneven access to buildings (hospitals,

health centres), inaccessible medical equipment, poor

signage, narrow doorways, internal steps and inadequate

bathroom facilities create barriers to health care facilities

For example: women with mobility difficulties are often

unable to access breast and cervical cancer screening

because examination tables are not height-adjustable

Inadequate skills and knowledge of health workers:

People with disabilities are more than twice as likely to

report finding health care provider skills inadequate to meet

their needs

BARRIERS TO HEALTH CARE

ADDRESSING BARRIERS TO HEALTH CARE

Governments can improve health outcomes for people with disabilities by improving access to quality, affordable health care services, which make the best use of available resources

Policy and legislation Assess existing policies and services, identify priorities to

reduce health inequalities and plan improvements for access and inclusion. Make changes to comply with the CRPD. Establish health care standards related to care of persons with disabilities with enforcement mechanisms

ADDRESSING BARRIERS TO HEALTH CARE

Service delivery Provide a broad range of modifications and adjustments

(reasonable accommodation) to facilitate access to health care services.

For example: changing the physical layout of clinics to provide access for people with mobility difficulties or communicating health information in accessible formats such as Braille, large print and pictorial

Promote community-based rehabilitation (CBR) to facilitate access for PWDs to existing services

Human resources Integrate disability education and continuing education for

all health-care professionals.

Blind since birth, Mr. X has experienced first-hand the effects of ignorance about disability within the health system. He recalls his blood being drawn as a child without anyone mentioning the needle prick would hurt.

“The nurse went through my fingers, saying how beautiful they were, then without warning she pushed the needle into my small finger," he says. "Of course it hurt, and my first reaction was to bite her hand. My point is the health workers should be taught how to properly deal with patients who have visual impairment. I believe that our rights as patients are equal to those of persons without disabilities.”

HOW TO INCLUDE PERSONS WITH DISABILITIES

Give persons with disabilities the information needed to live a long and healthy life

Listen and respond to their health concerns. Give PWDs the information needed to prevent or treat a health concern even if the person with disability does not ask for it. Health expert should offer information

Communication must be clear and direct with the patient in a language they understand. If PWDs don’t understand questions or instructions, repeat; use other words, or find another way to provide the information

WHAT HEALTH CARE PROVIDERS CAN DO

WHAT HEALTH CARE PROVIDERS CAN DO

source alternative communication options including large print, Braille, pictorial, audio and sign language based on individual requirements. These may be arranged through local disable peoples organizations and community based rehabilitation.

Take the time needed to meet the PWDs health care needs

THANK YOU