Should disability-inclusive health be a priority in low-income countries? A case-study from Zimbabwe

Abstract

The National Disability Policy was launched in Zimbabwe in June 2021 and includes a range of commitments for the provision of disability-inclusive health services and rehabilitation. Fulfilment of these pledges is important, as at least 7% of the population have disabilities, and people with disabilities face greater challenges accessing healthcare services and experience worse health outcomes. However, it will require financial investment which is challenging as the needs of people with disabilities are set against a background of widespread health systems failures in Zimbabwe, exacerbated by the COVID-19 pandemic. Zimbabwe currently faces an epidemic of TB and HIV and a growing burden of non-communicable diseases (NCDs) with a lack of investment, healthcare staff or infrastructure to provide the necessary care. Urgent action is therefore needed to strengthen the health system and ‘build back better’ after both the pandemic and the regime change. The Zimbabwean government may face the dilemma, common in many low-resource settings, of whether to focus on disability or to wait until the health system has been strengthened for the majority. This paper proposed four complementary arguments why it is important to focus on people with disabilities. First, this focus respects the rights of people with disabilities, including those specified in the new National Disability Policy. Second, it will be challenging to reach the Sustainable Development Goals, including those on health and other global health targets, without including people with disabilities. Third, there is a growing rationale that disability-inclusive health systems will work better for all, and fourth, that they will create cost savings. Everyone will therefore benefit when the health systems are designed for inclusion. In conclusion, a focus on disability may help to strengthen health systems for all as well as helping to achieve human rights and global development goals.

Co-development of a training programme on disability for healthcare workers in Uganda

“…Despite this range of possibility, there is limited collation or scrutiny of information, including input from people with disabilities and healthcare workers, to identify the most effective approach. Additionally, LMICs face unique challenges in healthcare provision, including resource constraints and limited access to education and training [ 13 ], which may contribute to the acute lack of training opportunities for healthcare workers. For instance, Uganda encounters significant challenges in training healthcare workers on disability due to limited resources, infrastructure, and cultural barriers that may stigmatise or exclude people with disabilities [ 14 – 16 ].…”

Functioning Problems Associated with Health Conditions with Greatest Disease Burden in South Africa: A Scoping Review

“…Many factors contribute to mobility problems requiring collaboration between all health care professionals including all disciplines of rehabilitation at primary care [ 317 ]. Foremost is the need for assistive devices, which have been reported to be inadequate in most poorly resourced public healthcare facilities in LMICs, one study [ 318 ] reporting that 36% of people requiring assistive devices in Zimbabwe acquired them but two thirds of these having to source them privately. Having funding allocated to mobility problems would ensure acquisition of adequate assistive devices and other rehabilitation services.…”