Limits...
Perceived Barriers for Accessing Health Services among Individuals with Disability in Four African Countries.

Eide AH, Mannan H, Khogali M, van Rooy G, Swartz L, Munthali A, Hem KG, MacLachlan M, Dyrstad K - PLoS ONE (2015)

Bottom Line: It is suggested that education reduces barriers to health services only to the extent that it reduces poverty.Persons with disability face additional and particular barriers to health services.Addressing these barriers requires an approach to health that stresses equity over equality.

View Article: PubMed Central - PubMed

Affiliation: SINTEF Technology and Society, Oslo, Norway; Stellenbosch University, Stellenbosch, South Africa.

ABSTRACT
There is an increasing awareness among researchers and others that marginalized and vulnerable groups face problems in accessing health care. Access problems in particular in low-income countries may jeopardize the targets set by the United Nations through the Millennium Development Goals. Thus, identifying barriers for individuals with disability in accessing health services is a research priority. The current study aimed at identifying the magnitude of specific barriers, and to estimate the impact of disability on barriers for accessing health care in general. A population based household survey was carried out in Sudan, Namibia, Malawi, and South Africa, including a total of 9307 individuals. The sampling strategy was a two-stage cluster sampling within selected geographical areas in each country. A listing procedure to identify households with disabled members using the Washington Group six screening question was followed by administering household questionnaires in households with and without disabled members, and questionnaires for individuals with and without disability. The study shows that lack of transport, availability of services, inadequate drugs or equipment, and costs, are the four major barriers for access. The study also showed substantial variation in perceived barriers, reflecting largely socio-economic differences between the participating countries. Urbanity, socio-economic status, and severity of activity limitations are important predictors for barriers, while there is no gender difference. It is suggested that education reduces barriers to health services only to the extent that it reduces poverty. Persons with disability face additional and particular barriers to health services. Addressing these barriers requires an approach to health that stresses equity over equality.

No MeSH data available.


Serious or insurmountable problems in accessing health care, by country.Percent.
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pone.0125915.g002: Serious or insurmountable problems in accessing health care, by country.Percent.

Mentions: The 18 items in <Fig 2 are ranked according to mean values across the four countries. Thus, lack of transport, no services available, inadequate drugs or equipment, and cost of the visit are the four major barriers as perceived by the respondents. The four barriers scoring lowest are faith/belief, lack of time due to other commitments, did not know where to go, and not sick enough. With two exceptions (lack of transport and faith/belief), respondents in Sudan have substantially higher scores than respondents from the other countries. The differences between countries are also statistically significant. The variation in barriers is also higher in Sudan than in the other countries (Table 1). Overall, respondents from South Africa and Namibia reported the lowest barriers. Exploratory factor analysis of the 18 items in <Fig 2 yielded a Cronbach's α of ∙92 and a KMO of ∙95, and supported a one component solution (scree plot, Eigenvalue >1).


Perceived Barriers for Accessing Health Services among Individuals with Disability in Four African Countries.

Eide AH, Mannan H, Khogali M, van Rooy G, Swartz L, Munthali A, Hem KG, MacLachlan M, Dyrstad K - PLoS ONE (2015)

Serious or insurmountable problems in accessing health care, by country.Percent.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4489521&req=5

pone.0125915.g002: Serious or insurmountable problems in accessing health care, by country.Percent.
Mentions: The 18 items in <Fig 2 are ranked according to mean values across the four countries. Thus, lack of transport, no services available, inadequate drugs or equipment, and cost of the visit are the four major barriers as perceived by the respondents. The four barriers scoring lowest are faith/belief, lack of time due to other commitments, did not know where to go, and not sick enough. With two exceptions (lack of transport and faith/belief), respondents in Sudan have substantially higher scores than respondents from the other countries. The differences between countries are also statistically significant. The variation in barriers is also higher in Sudan than in the other countries (Table 1). Overall, respondents from South Africa and Namibia reported the lowest barriers. Exploratory factor analysis of the 18 items in <Fig 2 yielded a Cronbach's α of ∙92 and a KMO of ∙95, and supported a one component solution (scree plot, Eigenvalue >1).

Bottom Line: It is suggested that education reduces barriers to health services only to the extent that it reduces poverty.Persons with disability face additional and particular barriers to health services.Addressing these barriers requires an approach to health that stresses equity over equality.

View Article: PubMed Central - PubMed

Affiliation: SINTEF Technology and Society, Oslo, Norway; Stellenbosch University, Stellenbosch, South Africa.

ABSTRACT
There is an increasing awareness among researchers and others that marginalized and vulnerable groups face problems in accessing health care. Access problems in particular in low-income countries may jeopardize the targets set by the United Nations through the Millennium Development Goals. Thus, identifying barriers for individuals with disability in accessing health services is a research priority. The current study aimed at identifying the magnitude of specific barriers, and to estimate the impact of disability on barriers for accessing health care in general. A population based household survey was carried out in Sudan, Namibia, Malawi, and South Africa, including a total of 9307 individuals. The sampling strategy was a two-stage cluster sampling within selected geographical areas in each country. A listing procedure to identify households with disabled members using the Washington Group six screening question was followed by administering household questionnaires in households with and without disabled members, and questionnaires for individuals with and without disability. The study shows that lack of transport, availability of services, inadequate drugs or equipment, and costs, are the four major barriers for access. The study also showed substantial variation in perceived barriers, reflecting largely socio-economic differences between the participating countries. Urbanity, socio-economic status, and severity of activity limitations are important predictors for barriers, while there is no gender difference. It is suggested that education reduces barriers to health services only to the extent that it reduces poverty. Persons with disability face additional and particular barriers to health services. Addressing these barriers requires an approach to health that stresses equity over equality.

No MeSH data available.