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Health equity for persons with disabilities: a global scoping review on barriers and interventions in healthcare services.

Published version
Peer-reviewed

Repository DOI


Change log

Authors

Gréaux, Mélanie 
Moro, Maria Francesca 
Kamenov, Kaloyan 
Russell, Amy M 
Barrett, Darryl 

Abstract

BACKGROUND: Persons with disabilities experience health inequities in terms of increased mortality, morbidity, and limitations in functioning when compared to the rest of the population. Many of the poor health outcomes experienced by persons with disabilities cannot be explained by the underlying health condition or impairment, but are health inequities driven by unfair societal and health system factors. A synthesis of the global evidence is needed to identify the factors that hinder equitable access to healthcare services for persons with disabilities, and the interventions to remove these barriers and promote disability inclusion. METHODS: We conducted a scoping review following the methodological framework proposed by Arksey and O'Malley, Int J Soc Res Methodol 8:19-32. We searched two scholarly databases, namely MEDLINE (Ovid) and Web of Science, the websites of Organizations of Persons with Disabilities and governments, and reviewed evidence shared during WHO-led consultations on the topic of health equity for persons with disabilities. We included articles published after 2011 with no restriction to geographical location, the type of underlying impairments or healthcare services. A charting form was developed and used to extract the relevant information for each included article. RESULTS: Of 11,884 articles identified in the search, we included 182 articles in this review. The majority of sources originated from high-income countries. Barriers were identified worldwide across different levels of the health system (such as healthcare costs, untrained healthcare workforces, issues of inclusive and coordinated services delivery), and through wider contributing factors of health inequities that expand beyond the health system (such as societal stigma or health literacy). However, the interventions to promote equitable access to healthcare services for persons with disabilities were not readily mapped onto those needs, their sources of funding and projected sustainability were often unclear, and few offered targeted approaches to address issues faced by marginalized groups of persons with disabilities with intersectional identities. CONCLUSION: Persons with disabilities continue to face considerable barriers when accessing healthcare services, which negatively affects their chances of achieving their highest attainable standard of health. It is encouraging to note the increasing evidence on interventions targeting equitable access to healthcare services, but they remain too few and sparce to meet the populations' needs. Profound systemic changes and action-oriented strategies are warranted to promote health equity for persons with disabilities, and advance global health priorities.

Description

Acknowledgements: The authors gratefully acknowledge the participants of the consultations for their valuable contributions, and are particularly thankful for inputs received from persons with disabilities and their representative organizations.

Keywords

Access, Barriers, Disability, Health equity, Healthcare services, Interventions, Persons with disabilities, Scoping review, Humans, Health Equity, Health Promotion, Health Services Accessibility, Disabled Persons, Health Care Costs

Journal Title

Int J Equity Health

Conference Name

Journal ISSN

1475-9276
1475-9276

Volume Title

22

Publisher

Springer Science and Business Media LLC
Sponsorship
Wellcome Trust (219754/Z/19/Z)