Can we achieve universal health coverage without a focus on disability? Results from a national case-control study in Guatemala

Kuper, Hannah; Mactaggart, Islay; Dionicio, Carlos; Cañas, Rafael; Naber, Jonathan; Polack, Sarah

doi:10.1371/journal.pone.0209774

Cited by 12 publications

(15 citation statements)

References 25 publications

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“…Furthermore, improving access will increase uptake of healthcare and so produce cost savings later down the line, by avoiding expensive health sequalae. It can also be argued that it will be difficult to achieve Universal Health Coverage, or the Sustainable Development Goals on Health, without provision of healthcare to this large and vulnerable group, and so a focus on accessibility is essential [ 29 , 30 ]. There are therefore a range of reasons for improving accessibility of healthcare facilities.…”

Section: Discussionmentioning

confidence: 99%

A National Accessibility Audit of Primary Health Care Facilities in Brazil—Are People with Disabilities Being Denied Their Right to Health?

Pinto

Köptcke

David

et al. 2021

IJERPH

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Poor accessibility of healthcare facilities is a major barrier for people with disabilities when seeking care. Yet, accessibility is rarely routinely audited. This study reports findings from the first national assessment of the accessibility of primary health care facilities, undertaken in Brazil. A national accessibility audit was conducted by trained staff of all 38,812 primary healthcare facilities in Brazil in 2012, using a 22-item structured questionnaire. An overall accessibility score was created (22 items), and three sub-scales: external accessibility (eight items), internal accessibility (eight items), information accessibility (six items). The main finding is that the overall accessibility score of primary care facilities in Brazil was low (mean of 22, standard deviation (SD) of 0.21, on a 0–100 scale). Accessibility of different aspects of the healthcare facilities was also low, including external space (mean = 31.0, SD = 2.0), internal space (18.9, 1.9) and accessibility features for people with other visual or hearing impairments (6.3, SD = 1.0). Scores were consistently better in the least poor regions of Brazil and in facilities in larger municipality size (indicating more urban areas). In conclusion, large-scale accessibility audits are feasible to undertake. Poor accessibility means that people with disabilities will experience difficulties in accessing healthcare, and this is a violation of their rights according to international and Brazilian laws.

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Section: Discussionmentioning

confidence: 99%

A National Accessibility Audit of Primary Health Care Facilities in Brazil—Are People with Disabilities Being Denied Their Right to Health?

Pinto

Köptcke

David

et al. 2021

IJERPH

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“…Nevertheless, people with disabilities remain the most vulnerable group in society, but people with disabilities are not explicitly mentioned in SDG-3 to ensure healthy lives for all [ 1 ]. Few have argued that without considering people with disabilities who have more significant health needs, the achievement of universal health care may not be genuinely inclusive [ 2 – 4 ].…”

Section: Introductionmentioning

confidence: 99%

Does disability increase households’ health financial risk: evidence from the Uganda demographic and health survey

Guets

Behera

2022

glob health res policy

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Background In the last few years, there has been a worldwide commitment to protect the vulnerable individuals from higher financial risk through out-of-pocket (OOP) health expenditure. This study examines the influence of disability and socio-demographic factors on households’ health financial risks in Uganda. Methods We used nationally representative cross-sectional data from the Uganda Demographic and Health Survey (UDHS) collected in 2016 by the Uganda Bureau of Statistics (UBOS) in Uganda. We measured financial risk (households’ health expenditure) by money paid for health care services. We estimated the “probit” model to investigate the effect of disability on health financial risk. Results A total of 19,305 households were included in this study. Almost 32% of households paid money for health care services access, among which 32% paid through out-of-pocket. Almost 41% of household heads were affected by disability. The majority (73%) of families went to the public sector for health care services. The mean age was 45 years (SD ± 15). We find that disability is significantly associated with the household financial risk (p < 0.01). The private sector’s choice for health care services is likely to positively affect the financial risk compared to the public sector (p < 0.01). The wealthier the household was, the more money paid for health service was (p < 0.01). Conclusion Our results indicated that disability and household socio-demographic characteristics were associated with health financial risk in Uganda. Identifying families with disability and experiencing difficult living conditions constitute an entry point for health authorities to enhance health coverage progress in low and middle-income countries.

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“…[3] https://dhsprogram.com/pubs/pdf/FR333/FR333.pdf [4] https://dhsprogram.com/data/dataset/Uganda_Standard-DHS_2016.cfm? ag=0 [5] It is important to note the number of family having access to health insurance through employer; social security; and other privately purchased commercial health insurance were quite low in Uganda.…”

Section: Methodsmentioning

confidence: 99%

“…Nevertheless, people with disabilities remain the most vulnerable group in society, but people with disabilities are not explicitly mentioned in SDG-3 to ensure healthy lives for all [1]. Few have argued that without considering people with disabilities who have more signi cant health needs, the achievement of universal health care may not be genuinely inclusive [2][3][4].…”

Section: Introductionmentioning

confidence: 99%

Does Disability Increase Households’ Health Financial Risk: Evidence From The Uganda Demographic and Health Survey

Guets¹,

Behera²

2021

Preprint

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Background: In the last few years, there has been a worldwide commitment to protect the vulnerable individuals from higher financial risk through out-of-pocket (OOP) health expenditure and provide a platform for universal access to healthcare through a pre-payment insurance mechanism. In a developing country like Uganda, OOP spending represents a significant component of health expenditure. Financial risk protection strategy for the vulnerable is always a debatable issue in these economies. Therefore, this study examines the influence of disability and socio-demographic factors on households’ health financial risks in Uganda.Methods: We used cross-sectional, nationally representative data from the Uganda Demographic and Health Survey (UDHS) collected in 2016 by the Uganda Bureau of Statistics (UBOS) in Uganda. We measured Financial risk (households’ health expenditure) by money paid for health care services. We estimated the “probit” model to investigate the effect of disability on health financial risk.Results: A total of 19,305 households were included in this study. Almost 33% of households paid money for health care services access, among which 32% paid through out-of-pocket. Almost 41% of household heads were affected by disability. The majority (73%) of families went to the public sector for health care services. The mean age was 45 years (SD±15). We find that disability significantly increases the probability of household financial risk (p < 0.01). The private sector’s choice for health care services is likely to increase the financial risk compared to the public sector (p < 0.01). The wealthier the household was, the more money paid for health service was (p < 0.01).Conclusion: Our results indicated that disability and household socio-demographic characteristics were associated with health financial risk in Uganda. Identifying families with disability and experiencing difficult living conditions constitute an entry point for health authorities to enhance health coverage progress in low – middle-income countries.JEL Classification: J14; I14; J1; I32; J71; C83

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Can we achieve universal health coverage without a focus on disability? Results from a national case-control study in Guatemala

Cited by 12 publications

References 25 publications

A National Accessibility Audit of Primary Health Care Facilities in Brazil—Are People with Disabilities Being Denied Their Right to Health?

A National Accessibility Audit of Primary Health Care Facilities in Brazil—Are People with Disabilities Being Denied Their Right to Health?

Does disability increase households’ health financial risk: evidence from the Uganda demographic and health survey

Does Disability Increase Households’ Health Financial Risk: Evidence From The Uganda Demographic and Health Survey

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