making cities inclusive and accessible for all. healthcare. clement

MAKING CITIES INCLUSIVE AND ACCESSIBLE FOR ALL:

Healthcare Access for Personswith Disabilities

Clement Nhunzvi (Mr)MSc OT (UCT), BSc HOT (UZ)

Lecturer, Department of RehabilitationCollege of Health Sciences,

University of Zimbabwe

Reflect Defining health and disability Legislation and Access Healthcare needs of persons with disabilities Access to healthcare Barriers to accessing healthcare services Human rights approach and Biopsychosocial

model: Parts of the solution.

Outline

If you were to meet a person with a disability on hospital grounds, Where would you take them to?

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Defining health & disability

Health is a resource for everyday life, not the objective of living.

Health is a positive concept emphasizing social and personal resources, as well as physical capacities.

Convention on the Rights of Persons with Disabilities

What is Disability? The CRPD does not explicitly define disability Preamble of Convention states:

‘Disability is an evolving concept, and that disability results from the interaction between persons with impairments and attitudinal and environmental barriers that hinders full and effective participation in society on an equal basis with others’

Article 1 of the Convention states: ‘Persons with disabilities include those who have

long-term physical, mental, intellectual or sensory impairments which in interaction with various barriers may hinder their full and effective participation in society on an equal basis with others’

Legislation and Access

Zimbabwe constitution 2013

Disabled Persons Act 1992 UNCRPD 2006 Public Health Act

1924/2002 Mental Health Act 1996 Zimbabwe Human Rights

Commission Act Chapter 10:30 (2/2012)

Healthcare Needs of Persons with Disabilities

Healthcare Needs of Persons with Disabilities

People with disabilities have healthcare needs like everyone else• To get and stay healthy, people with disabilities need to be able to obtain the healthcare they need when they need it, just like everyone else.• People with disabilities need healthcare professionals who really listen to, communicate with, and respect them.• They need professionals who see the person before the wheelchair.

My experience in healthcare practice - provider

•Wrong referrals to rehabilitation• People with disabilities share many of the same challenges as those without disabilities when it comes to their own health and well-being.• Foremost is having the tools and the knowledge – and knowledgeable healthcare professionals – to help them enjoy and maintain full, healthy lives.

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Access to healthcare service - Zimbabwe

Happens on a continuum though not independently accessible to a larger extent

Access to healthcare service - Zimbabwe

Access is actually required because PWDs are more prone to secondary conditions

Barriers to accessing healthcare services


• Physical/architectural barriers

• Communication barriers

• Attitudinal barriers • Social/economic

policy barriers


Sad to note how this coupled with attitudinal barriers can silence sound legislation

Insufficient knowledge and awareness of disability by the public, healthcare and wellness service providers, educators, administrators, the media and others

Healthcare professional and community attitudes and behaviours that see and respond only to the disability not to the whole person


Insufficient healthcare and wellness promotion services and information that is adapted for persons with disabilities.

Service systems that do not make use of innovative and creative approaches to enhance the health and wellness of persons with disabilities.


Human rights approach and Biopsychosocial model

Is there an accessible entrance to the facility? Is it clearly marked?

Are exam rooms accessible to wheelchair users? Was a sexual history taken? (often neglected due

to a stereotype of asexuality.) Are medical and non-medical staff trained to be

respectful and non-patronizing? Is there adequate time scheduled in the

appointment for the patient to adequately communicate without pressure to hurry?

Ensure that educational materials are easily accessible

Considerations

Research and training Provide access for people with disabilities to

healthcare services The law requires reasonable accommodation

– meaning those changes that are readily achievable and do not present an undue hardship on the facility

Practitioners and facilities need to learn about and provide specific accommodations for people with the full range of disabilities

Considerations

The challenges may be somewhat different for people who walk with difficulty, those who use walking aids, wheelchair users, people with a visual impairment (people who have difficulty seeing or people who are blind), people with hearing difficulties or people with intellectual disabilities.

There are a range of different features that are required if a building is to be fully accessible.

Building managers and city managers should ensure that the premises are designed to be accessible and that accessibility is maintained.

Considerations

Universal access to healthcare is healthcare that is reachable, affordable and acceptable to all those in need

THANK YOU

Conclusion