Health Inequalities in the Global South – barriers in access to healthcare for poor persons with disabilities in Cambodia

Accounting for about 15% of the world’s population, persons with disabilities constitute a critical population. Despite a substantial knowledge base in disability and public health, persons with disabilities have been remarkably invisible within general global public health. Public health’s view of disability is shifting from regarding disability only as an outcome to prevent, to using disability as a demographic characteristic that identifies a population experiencing a range of inequities. Alternative models of disability reflect how disability has been viewed over time. These models vary in their underlying values and assumptions, whether the locus of disability is the individual or the environment or their interaction, who designates “disability,” and the focus of intervention outcomes. The United Nations flagship report on Disability and Sustainable Development Goals, 2018 documents that, as a group, the lives of persons with disabilities are marked by large disparities in Sustainable Development Goal indicators. These include increased likelihood of experiencing poverty, hunger, poor health, and unemployment, and greater likelihood of encountering barriers to education and literacy, clean water and sanitation, energy, and information technology. Overall, persons with disabilities experience greater inequalities, and this is particularly experienced by women and girls with disabilities. The COVID-19 pandemic and other disasters have highlighted the gaps in equality and consequent vulnerability of this population. Global disability data have improved dramatically during the decade from 2010 to 2020 with the advent of standardized disability question sets (Washington Group) and model surveys (Model Disability Survey). New studies from the Global South and North identify areas and strategies for interventions that can effectively advance the Sustainable Development Goals. This call-to-action outlines strategies for increasing visibility and improving wellbeing of persons with disabilities, particularly in the Global South. Increased visibility of the disability population within the global public health community can be achieved through active engagement of persons with disabilities. Improved collection of disability data and routine analysis by disability status can provide information vital to planning and policies. A twin-track approach can provide direction for interventions—inclusion in mainstream programs where possible, use of disability-specific and rehabilitation approaches where necessary. The article ends by outlining ways that multiple roles can increase the inclusion of persons with disabilities in global public health.

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Health Outcomes and Health Inequalities

10.1093/oso/9780198860525.003.0002 ◽

2021 ◽

pp. 32-48

Author(s):

Simone M. Schneider ◽

Ave Roots ◽

Katharina Rathmann

Keyword(s):

Health Outcomes ◽

Health Inequalities ◽

Transition Point ◽

Access To Healthcare ◽

Data Sources ◽

Population Groups ◽

Measurement Issues ◽

Policy Context ◽

Potential Mediator ◽

Cross National

This chapter explains concepts and empirical variation regarding health outcomes, access to healthcare, and health inequalities. Access to healthcare is highlighted as a potential mediator or transition point linking characteristics of the broader policy context to health outcomes and their distribution across population groups. The chapter also discusses potential indicators and measurement issues considered relevant for cross-national comparative research and introduces the data sources and methodology for the figures that follow in the regional outlook and country chapters. It provides a short empirical overview of cross-national variation in health outcomes, health inequalities, and access to healthcare in Europe.

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Health Inequalities in the Global South: Transforming Inspiring Stories into Effective Policies

Technology s Stories ◽

10.15763/jou.ts.2018.05.14.03 ◽

2018 ◽

Cited By ~ 1

Author(s):

Judith Sutz

Keyword(s):

Health Inequalities ◽

Global South

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Qualitative exploration of sociocultural determinants of health inequities of Dalit population in Dhaka City, Bangladesh

BMJ Open ◽

10.1136/bmjopen-2018-022906 ◽

2018 ◽

Vol 8 (12) ◽

pp. e022906 ◽

Cited By ~ 2

Author(s):

Ashraful Kabir ◽

Mathilde Rose Louise Maitrot ◽

Ahsan Ali ◽

Nadia Farhana ◽

Bart Criel

Keyword(s):

Health Status ◽

Focus Group ◽

Health Inequalities ◽

Healthcare Services ◽

Access To Healthcare ◽

Dhaka City ◽

Focus Group Discussions ◽

Group Discussions ◽

Key Informant ◽

Depth Interviews

ObjectivesIn recent years, Bangladesh has made remarkable advances in health outcomes; however, the benefits of these gains are unequally shared among citizens and population groups. Dalits (jaatsweepers), a marginalised traditional working community, have relatively poor access to healthcare services. This study sought to explore the sociopolitical and cultural factors associated with health inequalities among Dalits in an urban setting.DesignAn exploratory qualitative study design was adopted. Fourteen in-depth interviews, five focus group discussions and seven key informant interviews were conducted. The acquired data were analysed using an iterative approach which incorporated deductive and inductive methods in identifying codes and themes.SettingsThis study was conducted in two sweeper communities in Dhaka city.ParticipantsParticipants were Dalit men and women (in-depth interviews, mean age±SD 30±10; and focus group discussions), and the community leaders and non-governmental organisation workers (key informant interviews).ResultsThe health status of members of these Dalit groups is determined by an array of social, economic and political factors. Dalits (untouchables) are typically considered to fall outside the caste-based social structure and existing vulnerabilities are embedded and reinforced by this identity. Dalits’ experience of precarious access to healthcare or poor healthcare is an important manifestation of these inequalities and has implications for the economic and social life of Dalit populations living together in geographically constrained spaces.ConclusionsThe provision of clinical healthcare services alone is insufficient to mitigate the negative effects of discriminations and to improve the health status of Dalits. A better understanding of the precise influences of sociocultural determinants of health inequalities is needed, together with the identification of the strategies and programmes needed to address these determinants with the aim of developing more inclusive health service delivery systems.

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Introduction

10.1093/oso/9780198846413.003.0001 ◽

2021 ◽

pp. 1-8

Author(s):

Michael Ashley Stein ◽

Jonathan Lazar

Keyword(s):

International Development ◽

Developed Countries ◽

Global South ◽

Information And Communications Technology ◽

Communications Technology ◽

Persons With Disabilities ◽

Legal Documents ◽

The Core

This chapter provides an introduction to the intersection of international development and digital accessibility, and provides an underpinning for the entire book. Most research on information and communications technology (ICT) accessibility and innovation for persons with disabilities has focused primarily on developed countries. Yet many of the most creative, innovative, and resource-conserving innovations are occurring in the Global South. In this chapter, the editors of the book introduce the core international efforts and legal documents related to accessible technology in the Global South, propose a number of reasons why researchers often miss the innovations and contributions occurring in the Global South, and offer an introduction to the chapters contained in the book.

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Critical Thinking on Disability and Development in the Global South

10.1093/oxfordhb/9780190093167.013.9 ◽

2021 ◽

Author(s):

Shaun Grech

Keyword(s):

International Development ◽

Research Policy ◽

Global South ◽

Critical Discussion ◽

Inclusive Development ◽

Persons With Disabilities ◽

The Sustainable Development ◽

Emerging Issues ◽

Global North ◽

Development Goals

The need to focus on disability in the Global South as an academic and practice endeavor has garnered some support in recent years, often backed by frequent references to a disability and poverty relationship, and a consequent need to link disability and international development. Indeed, calls for disability mainstreaming, disability targeting, and emerging discourse on disability-inclusive development (DID) have stepped up, accompanied by policy developments and declarations such as the United Nations Convention on the Rights of Persons with Disabilities (CRPD) and the sustainable development goals (SDGS). Despite these shifts, disability remains marginalized in development research, policy, and programs. Overall, there is a lack of critical discussion on “disability and development,” and difficult questions, including those regarding the implications of development for disabled people, are often forsaken in favor of an approach that seeks to simplify and generalize. The result is that accounts on disability and development are not only partial and fragmented but also neocolonizing. Inspired by critical disability studies and decolonial theory, this chapter reflects critically on some of these concerns, addressing emerging issues that arise when Global North disability discourse and “development” confront complex and dynamic heterogeneous Southern spaces and disability.

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Implications of the COVID-19 Pandemic and Responses on Persons with Disabilities Including Psychosocial Disabilities in the Global South: The Case of Ghana

The Coronavirus Crisis and Challenges to Social Development ◽

10.1007/978-3-030-84678-7_7 ◽

2022 ◽

pp. 77-85

Author(s):

Magnus Mfoafo-M’Carthy ◽

Augustina Naami

Keyword(s):

Global South ◽

Persons With Disabilities

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Socioeconomic Factors Hindering Access to Healthcare by Persons with Disabilities in the Ahanta West Municipality, Ghana

Disability CBR & Inclusive Development ◽

10.47985/dcidj.419 ◽

2021 ◽

Vol 32 (2) ◽

pp. 69

Author(s):

Henry Abuaku Howard ◽

Anastasia Baisiwa Rhule

Keyword(s):

Socioeconomic Factors ◽

Access To Healthcare ◽

Persons With Disabilities

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Accessible Technology and the Developing World

10.1093/oso/9780198846413.001.0001 ◽

2021 ◽

Keyword(s):

United Nations ◽

Developing World ◽

The United States ◽

Global South ◽

Information And Communications Technology ◽

Design Development ◽

Persons With Disabilities ◽

Non Governmental Organizations ◽

The World ◽

Global North

Most research on information and communications technology (ICT) accessibility and innovation for persons with disabilities, whether in the fields of law, tech, or development, has focused on developed regions (“Global North”) rather than developing parts of the world (“Global South”). The goal of this book is to increase awareness of ICT accessibility in developing areas, under three common themes. First, innovations created in developing states often get little attention, even though they are frequently less resource-intensive, and therefore more sustainable, than corresponding Global North solutions. Second, when Global South countries evolve their technology infrastructures (as many are doing now), it is important to avoid barriers to equal access for people with disabilities. Third, Global North design, development, and implementation techniques often will not transfer well to the Global South, and should not be applied without thought. Three international legal and policy initiatives ensuring accessibility and equal availability of ICT in developing areas are discussed: the United Nations Convention on the Rights of Persons with Disabilities, The Marrakesh Treaty to Facilitate Access to Published Works for Persons Who Are Blind, Visually Impaired or Otherwise Print Disabled, and the Sustainable Development Goals. This book brings together a unique combination of authors with diverse disciplinary backgrounds (technology, law, development, and education), from non-governmental organizations that are part of the public zeitgeist (the World Wide Web Consortium and Benetech), significant United Nations entities (the World Bank and G3ict), universities in the developing world (Pakistan and Uganda) and the developed world (the United States and Norway), and Global North industrial labs innovating in the Global South (Microsoft Research, India), among others.

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