Health care inequalities

Inclusive health: Government should be intentional in leadership – Yinka Olaito

“Any system which lays  a claim to embracing inclusive health must prioritise as well as be willing and ready to make changes to the traditional health system by taking deliberate efforts in ensuring there are structured accessible programmes which accommodate persons with disabilities”.

“When inclusive health becomes a priority, there are basic principles that must be followed. Two of these are vital. These are equitable access and full participation”. This will require adequate steps to ensure everyone has the access to services as well as resources to achieve personal health potentials, If these two principles are missing, we can forget all the claims.

The above and may others issues form the focus of discussion our executive Director, Yinka Olaito, pushed forward in a radio programme on Sobi FM (101.9FM) Ilorin today where he was guest expert on the topic: “Bridging the health gaps for persons with disabilities” The programme was aired on all the Sobi 101.9 FM channels.

The programme anchor, Dare Akogun, wanted the guest expert to identify challenges associated with inclusive health in Nigeria.

Yinka Olaito identified some of the followings:

Inadequate funding, Nigeria is yet to meet 15% of total health budget demand.

Lack of strong will to implement what is in the Discrimination against Persons with Disabilities Act 2019. Especially section 21 which focuses on inclusive health.

-Accessibility issue

-Lack of enough trained medical personnel who can handle the surge

-Lack of infrastructure

-Persistency lack of transparency in the use of scarce resources

– Lack of strong commitment from government to make necessary changes to medical practice and system

-While we have solid documents on the principles of inclusive health demand, there is no tangible structure which supports the will to do so.

While the 45 minutes’ session last, some other points emphasised by Yinka Olaito include:

-Appreciation of the little and consistency effort of the present leadership of National commission for Persons with Disabilities(NCPWD) which seems to be active

– A need for joint and collaborative efforts with relevant CSOs, disability advocacy groups operating in the sector to bring desired change.

-A call for an open and transparent structure that displays accountability which can allow well-meaning and philanthropic Nigerians to pull funds together in ensuring inclusive health as implementation will require adequate funding.

-Inclusive health benefits all and should be a priority

-Until government show good leadership, inclusive health may continue to be a mirage in Nigeria

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Health care inequalities

PWDs’ women  SRH in jeopardy.

Health is essential to every human being across the world. A healthy population brims a healthy economy. Access to good and quality health care is the right of all range of people in the country. As health is for a range of people, it seems the Nigeria health has not prioritized inclusive healthcare system, especially sexual reproductive health of women and girls with disabilities. There have been no concrete plans which accommodate women and girls living with disabilities in sexual reproductive health package at different levels of governments in Nigeria. 

This had prevented many women, girls with disabilities from getting adequate sexual reproductive health(SRH) attention. The followings are the foundations as well as outcomes of such neglect.

Stigmatization and discrimination: Stigmatization and discrimination are attitudinal derogations which women and girls with disabilities are daily facing in their bid to benefit from quality and accessible sexual reproductive  healthcare, if that exist in the first instance.

The pivotal agents of these attitudinal derogations are the health workers who sometime indirectly abuse patients who have disabilities. Stigmatization and discrimination by health workers affect patients mentally. This often lead to depression or other mental-related issues. A visually-impaired patient once shared how she was once discriminated against, tactically insulted by a health worker. Since she  had decided not to go to public hospital again

Health Investment deficit: Inadequate financing of the health sector reflects in lack of assistive devices, accessible technology that can aid women and girls with disabilities sexual reproductive health diagnosis and management. 2023 Nigeria ‘budget only enjoys 5.75% of the total budget. Meanwhile African Leaders under the Abuja Declaration had advocated for a base of at least 15% of the annual spending to the sector.

Communication barriers: As already identified in a previous post, individuals with hearing. speech and visual impairments continued to be left behind. There is shortage of social health social workers trained in sign language etc who can help in many public and private hospitals

Long waiting time; Long waiting time is a common factor for majority of people looking for health care in public health institutions. For women with disabilities, sitting down for long or waiting for a whole day sometime can really be a burden. A great solution here can be priority in consultation for women and girls with disabilities  so as to reduce this discomfort

Transportation and distance: with the increase in cost of living standard that is not backed up with commensurate purchasing power for many, especially persons with disabilities, many of whom are not gainfully employed; the challenge becomes compounded. Yes, there are Primary health Care centres, but some are not fully equipped to care for women and girls with disabilities ‘sexual reproductive health needs.

Limited PWD sexual and reproductive health materials: For women without disabilities, there are couples of materials here and there they can access, read to be informed of what sexual and reproductive health challenges and opportunities can present to them. But with women and girls with disabilities, not much materials are available out there when compared with women without disabilities

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Health care inequalities

Healthcare Inequities: The Battle for Access Amongst Nigeria’s Disabled Population

Accessible and inclusive healthcare is a fundamental human right, and it should be no different for people with disabilities in Nigeria. However, for far too long, individuals with disabilities have faced numerous barriers when seeking medical services.  There are several reasons why inclusive health has been a challenge in Nigeria and in some other African societies. Here we itemised our findings.

1.Discrimantion, prejudices and disrespect: The number one issue here is the discrimination and prejudice within the healthcare system. Some individuals with disabilities report being treated disrespectfully or even denied care due to their disability. This discrimination creates a hostile environment that deters people from seeking medical assistance when needed.

2-Inaccessible physical structures: While there have been improvements over the years, much needs to be done about the physical infrastructure of many healthcare facilities across Nigeria as most are still inaccessible to people with disabilities. Some basic facilities like widened doorways and accessible restrooms are rare. With these, navigating the uneven terrain of hospitals and clinics becomes an arduous task for individuals with mobility impairments.

3, Effective communications: Effective communication between healthcare providers and patients is essential. How does a certain Persons with disabilities (especially persons with speech and hearing impairment of some intellectual developmental challenge etc) communicate their ailments if the doctor or nurse doesn’t speak their ‘language’. Trained social workser who could do this are always in short supply or absent in many hospitals,

In Nigeria, individuals with hearing or speech impairments often struggle to convey their medical concerns. Lack of sign language interpreters and alternative communication methods further worsens these communication challenges.

4- No access to healthcare information: Also, access to healthcare information in formats suitable for individuals with disabilities is severely lacking. Braille materials, audio resources, or materials in large print are rare, making it difficult for individuals with visual impairments to understand their medical conditions, treatment options, and prescriptions.

In addition to this, some healthcare professionals, while well-intentioned, often lack the training required to provide appropriate care to individuals with special needs and disabilities. This includes understanding the unique needs and challenges these patients face and how to make necessary accommodations.

5-Quality primary health for special needs can be too far away: Accessing healthcare services often involves travel, and public transportation is frequently inaccessible to people with disabilities. This lack of transportation options means that individuals may have to rely on costly private transportation or forgo medical appointments altogether.

While Nigeria has made progress in recognizing the rights of people with disabilities, there are still gaps in policies and regulations that need to be addressed. Ensuring that healthcare facilities are accessible and that discrimination is prohibited in all healthcare settings is crucial.

Addressing these barriers requires a concerted effort from all stakeholders. The government, healthcare institutions, advocacy groups, and the community must collaborate to create a more inclusive healthcare system. Initiatives such as accessible infrastructure, specialized training for healthcare professionals, and awareness campaigns can significantly improve the situation.

In conclusion, it is imperative that Nigeria takes concrete steps to remove these barriers and ensure that individuals with disabilities can access medical services on an equal basis with others. Recognizing that diversity and inclusivity are our strengths, we must work collectively to ensure that healthcare is a right accessible to all, regardless of their abilities.

6-Policy formations not enough: It’s not just about changing policies; it’s about transforming attitudes and building a more compassionate and inclusive society for all Nigerians. The journey towards inclusive healthcare requires the collective effort of government, healthcare providers, advocacy groups, and the community at large. By working together, we can ensure that every Nigerian, regardless of their abilities, has equal access to the medical care they deserve. It’s not only a matter of policy; it’s a matter of humanity.

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