ACCESS TO HEALTHCARE SERVICES AMONG STUDENTS WITH DISABILITIES IN GHANA

ABSTRACT
The purpose of the study was to investigate access to healthcare services among students with disabilities (SWDs) in Ghana. Specifically, the study sought to examine accessibility to physical structures of healthcare facilities to students with disabilities, examine the attitude of healthcare providers to SWDs, availability of support services for SWDs in the healthcare facilities and how healthcare service bills are funded by SWDs. I employed qualitative research design dwelling on the phenomenological approach for the study. Purposive sampling technique was used to select a total of 54 participants, which comprises 29 SWDs from the three special schools, 17 healthcare providers (nurses and doctors) and 8 school-mothers for the study. Interview guide was used for data collection. The interview data were transcribed, coded and analysed thematically. The study revealed further that the physical structures of healthcare facilities, inadequate healthcare facilities and financial accessibility were problematic to SWDs in accessing healthcare services in Ghana. The study revealed that the attitudes of healthcare providers towards SWDs were good. Based on the findings, recommendations were made to the Ministries of Health and Housing to revisit existing building regulations and policies to redesign buildings to ensure more disability friendly healthcare structures that will be accessible to SWDs.


CHAPTER ONE
INTRODUCTION
Background to the Study
The health services needs of persons with disabilities is increasingly acknowledged as a research priority (Tomlinson et al., 2009; Mannan & MacLachlan, 2013). The United Nations Convention on the Right of Persons with Disabilities (UNCRPD) (2006) recognised access to health services for people with disabilities at all levels of service provision in a country. Article 29 of Ghana’s constitution and the Disability Act (2006) specifically mandates state agencies to ensure that people with disabilities enjoy equal level of access to health services as the general population without discrimination on the basis of their disabilities. The mandates of these state agencies further confirm the 1946 World Health Organisation (WHO) constitution and the Alma Ata declaration of primary health care in 1970, which emphasized the need for equity, social justice, and health for all; community participation; health promotion and appropriate use of resources (WHO, 1946; Lawn et al., 2008). These international regulations specifically promote access to health services for citizens including people with disabilities. The WHO constitution for instance, encourages state agencies to treat access to health services as a human right issue, of which persons with disabilities are not exempted. The efforts demonstrated over the past decades are geared towards achieving universal health coverage for all citizens. In recent developments, the health care needs for persons with disabilities have been spelt out in the Sustainable Development Goals (SDGs) (UNDP, 2000). Section 3 of the SDGs promotes the need for state agencies to ensure that persons with disabilities are factored in at all stages of health service provision. The 1992 Constitution of Ghana Article 29 clause 6 states that “as far as practicable, every place to which the public has access shall have appropriate facilities for disabled persons’’ In spite of these efforts, persons with disabilities face numerous access barriers to health care (Badu, 2014).

Globally, access to healthcare among persons with disabilities seems to differ across countries and communities (Rimmer, Riley, Wang, Rauworth & Jurkowski, 2004). Persons with disabilities lag behind other citizens in accessing health care (Rimmer et al., 2014). Persons with disabilities face access barriers to healthcare particularly in low-middle income countries and widen the access gap between themselves and their counterparts in the developed world (Action on Disability and Development, 2005). It is estimated that 5.8% of persons with disabilities around the world do not get care when needed as compared with 3.9% of the non-disabled population (WHO, 2011). Drainoni, Lee-Hood, Bachman, Andrew and Maisels (2006) stated that persons with disabilities may receive healthcare to some extent, however, their satisfaction with the care they receive is low due to delays and frustration. Thew, Smith, Chang, and Starr (2012) and Iezzoni, O’Day, Killeen, and Harker (2004) revealed that hearing impaired patients had fear, mistrust and frustration in healthcare settings when they experience problems with instructions for physical examination, telephone communication, and difficulty in communicating with staff. This may lead to incorrect diagnosis and wrong treatment.

Access to healthcare by persons with disabilities (PWDs) in Ghana is limited despite its emphasis in the disability Act 2006 which calls for effective healthcare and adequate medical rehabilitation service (Mensah, Oppong & Schmidt, 2010). Facilities at the various health centres do not provide disability friendly services making it difficult for most clients, especially wheelchair users, to access hospital buildings and climb onto medical examination beds (Mensah et al., 2010). Vulnerable groups including PWDs have differential needs in accessing health care but there is inadequate recognition by stakeholders to specifically identify the differences in need. It implies that policy makers find it difficult to incorporate the needs of disable persons into policy documents and are also unable to integrate these policies in the implementation process (Schneider, Eide, Amin, MacLachlan & Mannan, 2013). Taking together inaccessible physical structure, inadequate skills and knowledge of health workers, limited availability of services, present barriers that hamper persons with disability from accessing healthcare. Notwithstanding, there appears to be very limited research that establishes a direct relationship between these barriers and students with disability in special schools.

Hence the gap in healthcare research among persons with disabilities is to identify empirically barriers that exist in health service delivery in special schools. Although these barriers are widespread in public health delivery, it is not the case with special schools. It is not clear for instance, whether educators, policy makers, parents and other stake holders are aware of the barriers students with disabilities face in accessing health services in special schools, which in turn affect not only their health but learning, assessment, performance, and class attendance (Hugo, 2013).

The Office of the Surgeon General (2005) noted that the consequence of persons with disabilities failing to receive appropriate, coordinated healthcare as the result of access difficulties alone can result in poor health and increased secondary conditions. Taking a cue from Tomlinson et al. (2009) and Mannan and MacLachlan (2013), there is the need to investigate how special education research can contribute to an increased awareness and understanding of students with disabilities experiences of accessing health services.

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Item Type: Ghanaian Project Material  |  Attribute: 143 pages  |  Chapters: 1-5
Format: MS Word  |  Price: GH110 ($20)  |  Delivery: Within 30Mins.
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