Background: The United Nations (UN) Convention on the Rights of Persons with Disabilities (CRPD) is a milestone in the recognition of the human rights of persons with disabilities, including the right to health and rehabilitation. South Africa has signed and ratified the CRPD but still has a long way to go in reforming policies and systems in order to be in compliance with the convention. This paper seeks to fill a gap in the literature by exploring what the barriers to the implementation of the health and rehabilitation articles of the CRPD are, as identified by representatives of the disability community. Methods: This investigation used a qualitative, exploratory methodology. 10 semi-structured interviews of a purposive sample of representatives of disabled persons organizations (DPOs), non-governmental organizations (NGOs), and service providers in South Africa were conducted. Participants were drawn from urban, peri-urban, and rural settings in order to reflect diverse perspectives within South Africa. Data was analysed using a multi-stage coding process to establish the main categories and relationships between them. Results: Six main categories of barriers to the implementation of the health and rehabilitation articles of the CRPD were identified. Attitude barriers including stigma and negative assumptions about persons with disabilities were seen as an underlying cause and influence on all of the other categories; which included political, financial, health systems, physical, and communication barriers. Conclusion: The findings of this study have important implications for strategies and actions to implement the CRPD. Given the centrality of attitudinal barriers, greater sensitization around the area of disability is needed. Furthermore, disability should be better integrated and mainstreamed into more general initiatives to develop the health system and improve the lives of persons living in poverty in South Africa.
This study described the benefits, challenges, and support needs of siblings of people with intellectual disabilities in Latin America, Africa, and Asia-Pacific. Background: Growing up with a sibling with an intellectual disability can influence young people in various ways. Previous research has focused primarily on Western contexts and the use of parent rather than sibling perceptions. Method: Twenty-two siblings of people with intellectual disabilities between ages 8 and 25 years participated in three semistructured focus groups during Special Olympics Regional Sibling and Family Workshops. Participants discussed their personal experiences and perceived support needs. Transcripts were coded for themes and subthemes using an iterative process. Results: Thematic analysis revealed positive themes related to valuing siblings with intellectual disabilities, close relationships, and personal growth. Challenging themes found were related to the self, family, and broader community. For supports needed, themes included future planning and services for siblings with intellectual disabilities. Conclusion: Siblings from these regions described their experiences as a combination of benefits and challenges, noting the distinct influence of stigma on their relationships and the need for higher quality services. Implications: Findings point to a need for a whole-familycentered approach to support siblings of people with intellectual disabilities in the Global South.
How can systems thinking address the barriers to implementing the right to health and rehabilitation in South Africa? This chapter will use systems thinking to understand barriers to implementing the UN Convention of the Rights of Persons with Disabilities (CRPD) in South Africa. It will first examine the rights of persons with disability as a global health issue and how disability is constructed within global health systems. It will then identify major barriers to implementing the health and rehabilitation articles of the CRPD in South Africa including negative attitudes, competing political priorities, lack of available finances, cumbersome organizational structures, inaccessible physical environments, and poor communication practices. It is necessary to look at structural inequality and how historical legacies perpetuate disparities in the health system that make it difficult to implement the CRPD. Furthermore, this chapter illustrates how underlying negative attitudes toward persons with disabilities influence barriers within the health system.
The EquiFrame analytical tool provided the framework for evaluation of the inclusion of Core Concepts of Human Rights as well as Vulnerable Groups in the Law. Results: China's Mental Health Law scored 83% for Core Concept coverage, with a Core Concept Quality score of 76%. The Law had a 42% score for Vulnerable Groups coverage. This gave the Law an overall score of "Moderate" in terms of Human Rights coverage. Conclusions: China's Mental Health Law is a landmark document providing the country's first ever legal framework for mental health. While the Law scores high on level commitment in Core Concepts of Human Rights, the potential for equitable protection would be enhanced by increased inclusion of Vulnerable Groups. Limitations: Further analyses of health and social policies in the People's Republic of China from a Human Rights perspective would provide a deeper understanding of the Law in context.
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