Working to remove barriers to health care for people with disabilities

On this Human Rights Day, and in recognition of the International Day of Disabled Persons (3 December), the World Health Organization Regional Office for the Western Pacific calls on governments and civil society to ensure that people with disabilities have equal access to health care.

The right to health care is enshrined in Article 25 of the Universal Declaration of Human Rights. Still, people living with disabilities routinely encounter barriers. They also face discrimination by health-care workers who may lack training to deal with patients with disabilities.

"Access to health services is a key issue for WHO," says Dr Shin Young-soo, WHO Regional Director for the Western Pacific. "The goal of universal health coverage is achieved only through measures that address the barriers that people with disabilities experience.”

Barriers can take many forms and may relate to the physical environment, to information and communications technology, to legislation or policy, or to societal attitudes.

Studies show that people with disabilities seek more health care than people without disabilities and have greater unmet needs. They also show that health promotion activities seldom target people with disabilities. For example, women with disabilities receive less screening for breast and cervical cancer than women without disabilities. Similarly, people with both intellectual impairments and diabetes are less likely to have their weight checked, and adolescents and adults with disabilities are more likely to be excluded from sex education programmes.

People with disabilities can face financial barriers to access of health services. Depending on the type of disability, people with disabilities may experience difficulty finding a job or earning adequate income. When a social safety net is lacking, people with disabilities are at risk of poverty and vulnerable to catastrophic health-care costs. As countries strive to attain universal health coverage, special attention must be paid to the specific needs of people with disabilities.

In the Western Pacific Region, many low- and middle-income countries lack adequate disability policies and legislative frameworks, as well as rehabilitation programmes and services. Such services tend to be most available in urban areas and least at the community level and in rural areas.

Ronnel del Rio, a broadcast journalist in the Philippines, says that governments should prioritize marginalized sectors of the population, including people with disabilities, and ensure that health-care workers are trained to deal with them.

Blind since birth, Mr del Rio 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.”

Evidence and experience show that when barriers to their inclusion are removed and persons with disabilities are empowered to participate fully in societal life, their entire community benefits.

“Every person with disability must have universal health-care protection, and we have equal rights as patients," he says. "Health professionals should at all times be sensitive to all types of patients and always consider the rights of patients with disabilities."

WHO works with its Member States in the development and implementation of policies and programmes to improve access to health care for people with disabilities. It promotes public awareness and political commitment regarding the rights of people with disabilities and the need for multisectoral approaches to achieve these. WHO focuses on support for rehabilitation services, community-based rehabilitation and assistive technology. It also contributes to the development of disability data and surveillance. WHO builds on efforts to ensure that the delivery of health-care services is inclusive of people with disabilities.

Ten key messages about people with disabilities and the right to health care:

  • Disability is everyone’s business.
  • People with disabilities are not necessarily sick.
  • People with disabilities have sex too.
  • 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.
  • 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.