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 Topic | Size: 143 pages | Chapters: 1-5
Format: MS Word | Delivery: Within 30Mins.
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