Worldwide, the utilisation of health care services are higher in persons with disabilities than persons without disabilities. Women with disabilities also seek care more often than others.
According to the World Health Survey in the World Report on Disability, people with disabilities, especially women with disabilities, were significantly more likely than people without disabilities to not receive health care services that they needed due to the multiple barriers they face. With poorer access to health care, persons with disabilities are at higher risks of poorer health – a vicious cycle.
People with disabilities in Malaysia continue to face multiple barriers in accessing basic health care services, including:
Health care services for people with disabilities do not end at “it is available to PWDs” – which is the approach currently adopted in Malaysia.
People with disabilities have the right to access quality health care services that improve our quality of life, and a health care provision that is accessible in all aspects, including communication, information, affordability, facilities and infrastructure.
A total transformation of health care services in Malaysia is necessary, not just because the survival, health and quality of life of people with disabilities depend on it, but also because disability-inclusive health care services benefit others: those without disabilities and those with temporary or situational disabilities.
Besides ensuring accessibility in the provision of health care services, other underlying issues that contribute to poorer access to health care in people with disabilities also need to be addressed, such as:
As women and girls with disabilities face greater risk of poor health outcomes and gender-based violence, a gender-sensitive and trauma-sensitive approach to provision of care is critical to ensure the health outcomes and wellbeing of women and girls with disabilities.
Making health care services accessible to everyone, not just people with disabilities, will significantly improve the experiences of navigating health care services, which can be overwhelming and complicated. Patients with and without disabilities and their caregivers or care partners will better understand the importance of taking medication as instructed, feel comfortable asking questions, feel less anxious being in a hospital, etc.
Some adaptations for accessibility are simple and easy to make to the existing mode of health care provision, and some require planning to implement. Of course, accessibility of the physical environment of health care facilities is best made from the beginning, i.e., designing the physical building and procurement of equipment.
It is best practice to involve and listen to persons from diverse disability groups in any planning of health care services, from the beginning to the end of the whole process. This includes making plans to retrofit or renovate the existing physical environment for accessibility and building new health care facilities. Similarly, co-designing and co-delivering disability-related health care training together with persons with disabilities will enhance the skills and knowledge of health care service providers in supporting persons with disabilities.
Below lists the basic strategies that make health care services accessible to ALL:
*Note: Resources linked are in English and pdf format, unless stated otherwise.
Disability and Health by World Health Organization
Women with Disabilities: Healthcare Barriers in RUH Global Impact
Barriers in access to healthcare for women with disabilities: a systematic review in qualitative studies by Behzad Karami Matin, et al. in BMC Women’s Health
Encountering Ableism in Health care by Lelaina Lloyd in NeuroMyelitis News
Disabled Doctors Were Called Too ‘Weak’ To Be In Medicine. It’s Hurting The Entire System. By Wendy Lu for Huffington Post
Ableism in the medical profession by Shane Neilson in Canadian Medical Association Journal
World Report on Disability by World Health Organization and World Bank
Access to health for persons with disabilities by Tom Shakespeare, Tess Bright and Hannah Kuper for The Office of the United Nations High Commissioner for Human Rights
Report on the rights of persons with disabilities to the highest attainable standard of physical and mental health by UN Special Rapporteur on the rights of persons with disabilities
Report on the impact of ableism in medical and scientific practice by UN Special Rapporteur on the rights of persons with disabilities
“It’s Not Rocket Science”: Considering and meeting the sensory needs of autistic children and young people in CAMHS inpatient services by National Development Team for Inclusion, UK
Impact of Patient Communication Problems on The Risk of Preventable Adverse Events in Acute Care Settings by Gillian Bartlett, Régis Blais, Robyn Tamblyn, Richard J. Clermont and Brenda MacGibbon in Canadian Medical Association Journal
Adults with Developmental Disabilities: A Comprehensive Approach to Medical Care by Clarissa Kripke in American Family Physician
Adults with Communication Disabilities Experience Poorer Health and Health care Outcomes Compared to Persons Without Communication Disabilities by Michelle L. Stransky, Kristin M. Jensen and Megan A. Morris in Journal of General Internal Medicine
The Current State of Health Care for People with Disabilities (US) by The National Council on Disability
Medical treatment and care of people with disabilities by Swiss Academy of Medical Sciences
Health Care for Adults with Intellectual and Developmental Disabilities: Toolkit for Primary Care Providers by IDD Toolkit Project Team, Vanderbilt Kennedy Centre
Health Guidelines for Adults with an Intellectual Disability by University of Hertfordshire
Modernizing Health Care to Improve Physical Accessibility by Centers for Medicare and Medicaid Services