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The United Nation Convention on the Rights of Persons with Disabilities upholds the rights of people with disabilities to access health services. The Disability- inclusive Health Services Toolkit: A Resource for Health Facilities in the Western Pacific Region supports the rights of people with disabilities to have the same access to health services as people without disabilities. The Toolkit provides practical guidance to managers and staff of health-care facilities and services, health policy-makers, and nongovernmental organizations on identifying and addressing barriers to health information and services. The Toolkit supports the achievement of universal health coverage (‎UHC)‎ by ensuring everyone can access health information and can benefit equally from health services.

This situational analysis (SITAN) addresses the question: “what is the current situation for persons with disabilities in Nepal?”. It has been prepared for the Disability Inclusive Development programme (which works on access to education, jobs, healthcare, and reduced stigma and discrimination for persons with disabilities in Bangladesh, Jordan, Kenya, Nepal, Nigeria, and Tanzania), to better understand the current context, including COVID-19, and available evidence in Nepal. It will be helpful for anyone interested in disability inclusion in Nepal, especially in relation to stigma, employment, education, health, and humanitarian issues. This SITAN has been briefly updated from the April 2019 SITAN.

This situational analysis (SITAN) addresses the question: “what is the current situation for persons with disabilities in Bangladesh?”. It has been prepared for the Disability Inclusive Development programme (which works on access to education, jobs, healthcare, and reduced stigma and discrimination for persons with disabilities in Bangladesh, Jordan, Kenya, Nepal, Nigeria, and Tanzania), to better understand the current context, including COVID-19, and available evidence in Bangladesh. It will be helpful for anyone interested in disability inclusion in Bangladesh, especially in relation to stigma, employment, education, health, and humanitarian issues.

Gaining access to healthcare is often a challenge for people with disabilities in low- and middle-income countries. Part of this has to do with a general dearth of healthcare services in low-resource settings. But part of this difficulty has to do with structural, attitudinal, economic and social barriers to participation and healthcare which affect people with disabilities more than people without disabilities. This lack of access to healthcare is a problem because, in general, people with disabilities may need to access healthcare more frequently than people without disabilities. Full and equitable access to quality healthcare is a human right, and an important imperative of the global agenda. This evidence brief summarises what we know about how to improve access to healthcare for people with disabilities in low-resource settings.

The Sustainable Development Goals (SDGs) are a set of goals designed to improve the social, economic and well-being of all, while maintaining global and environmental sustainability. Health is one of the 17 goals, and focuses not only on addressing morbidity and mortality, but also on improving access to healthcare services for all through Universal Health Coverage (UHC). While disability is not specifically mentioned in this goal, a focus on people with disabilities is important given the inclusive nature of the SDGs and the fact that people with disabilities make up the largest minority group in the world. This paper aims to critically consider what the health goal could mean for people with disabilities and advocates for inclusive health. It discusses the complex relationship between disability and health, and why people with disabilities are more vulnerable to poor health are discussed, and then considers factors that impact access to quality healthcare for people with disabilities and how these impact on the achievement of the targets in SDG Health Goal and the main principles of UHC. The paper argues that developing an inclusive approach to healthcare will not only improve achieving good health for all, but is also important since experiencing poor health may reduce quality of life and participation (e.g. in education, employment or community activities). Poor quality of life and participation can exacerbate disability, poverty and exclusion in addition to increasing suffering, morbidity and early mortality. The paper concludes that an inclusive UHC will not only fulfil the fundamental rights of people with disabilities to health and rehabilitation, as emphasized within the UN Convention on the Rights of Persons with Disabilities, but also contribute to the achievement of the SDGs.

Disability & the Global South (DGS), 2017, Vol. 4 No. 1

Purpose: User satisfaction with assistive devices is a predictor of use and an important outcome measure. This study evaluated client satisfaction with prosthetic and orthotic assistive devices and services in three provinces in the Lao People’s Democratic Republic.

Method: A cross-sectional study was done, using the Quebec User Evaluation of Satisfaction with Assistive Technology questionnaire. The sample was drawn from the client register of three of the five Rehabilitation Centres in the country which are under the Ministry of Health’s Centre for Medical Rehabilitation. Clients were eligible if they had received their device in the 12 months prior to the study. Based on the number of registered clients, the sample size was calculated as 274 with a 95% confidence interval, with the final sample N = 266. Qualitative semi-structured interviews were also conducted (N = 34).

Results: Most of the assistive devices were in use at the time of the survey and were reported to be in good condition (n = 177, 66.5%). The total mean score for satisfaction (services and device combined) was 3.80 (SD 0.55). Statistically significant differences were observed in satisfaction between gender and location of residence. Effectiveness and comfort were rated as the two most important factors when using a device; at the same time, these were the most common reasons for dissatisfaction and sub-optimal use.

Conclusion and Implications: Clients were quite satisfied with the assistive device and services provided, yet many reported barriers to optimal device use and difficulties in accessing follow-up services. There is a need to examine how prosthetic and orthotic devices can be improved further for better comfort and ambulation on uneven ground in low-resource contexts and to address access barriers.