Impacts of the COVID-19 pandemic on access to healthcare among people with disabilities: evidence from six low- and middle-income countries

Xanthe Hunt; Shaffa Hameed; Shailaja Tetali; Luong Anh Ngoc; John Ganle; Lopita Huq; Tom Shakespeare; Tracey Smythe; Zeynep Ilkkursun; Hannah Kuper; Ceren Acarturk; Nanda Kishore Kannuri; Vu Quynh Mai; Rifat Shahpar Khan; Lena Morgon Banks

doi:10.1186/s12939-023-01989-1

Impacts of the COVID-19 pandemic on access to healthcare among people with disabilities: evidence from six low- and middle-income countries

Int J Equity Health. 2023 Aug 31;22(1):172. doi: 10.1186/s12939-023-01989-1.

Authors

Affiliations

¹ Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Room 4009, Education Building, Cape Town, South Africa. xanthehuntwrites@gmail.com.
² International Centre for Evidence on Disability, London School of Hygiene and Tropical Medicine, London, UK.
³ Indian Institute of Public Health-Hyderabad, Hyderabad, India.
⁴ Center for Training and Research on Substance Abuse - HIV, Hanoi Medical University, Hanoi, Viet Nam.
⁵ School of Public Health, University of Ghana, Accra, Ghana.
⁶ BRAC Institute of Governance and Development, BRAC University, Dakar, Bangladesh.
⁷ Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
⁸ Department of Psychology, Koc University, Istanbul, Türkiye.
⁹ Center for Population Health Science, Hanoi University of Public Health, Hanoi, Viet Nam.

Abstract

Background: The pandemic has placed considerable strain on health systems, especially in low- and middle-income countries (LMICs), leading to reductions in the availability of routine health services. Emerging evidence suggests that people with disabilities have encountered marked challenges in accessing healthcare services and supports in the context of the pandemic. Further research is needed to explore specific barriers to accessing healthcare during the pandemic, and any strategies that promoted continued access to health services in LMICs where the vast majority of people with disabilities live.

Methods: Qualitative in-depth interviews were conducted with persons with disabilities in Ghana, Zimbabwe, Viet Nam, Türkiye (Syrian refugees), Bangladesh, and India as part of a larger project exploring the experiences of people with disabilities during the COVID-19 pandemic and their inclusion in government response activities. Data were analysed using thematic analysis.

Results: This research found that people with disabilities in six countries - representing a diverse geographic spread, with different health systems and COVID-19 responses - all experienced additional difficulties accessing healthcare during the pandemic. Key barriers to accessing healthcare during the pandemic included changes in availability of services due to systems restructuring, difficulty affording care due to the economic impacts of the pandemic, fear of contracting coronavirus, and a lack of human support to enable care-seeking.

Conclusion: These barriers ultimately led to decreased utilisation of services which, in turn, negatively impacted their health and wellbeing. However, we also found that certain factors, including active and engaged Organisations of Persons with Disabilities (OPDs) and Non-Governmental Organizations (NGOs) played a role in reducing some of the impact of pandemic-related healthcare access barriers.

Keywords: COVID-19; Healthcare access; Inclusive healthcare; Lockdown; Pandemic; People with disabilities.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

COVID-19*
Developing Countries
Disabled Persons*
Health Services Accessibility
Humans
Pandemics