6.5.1 Health
The situation
As mentioned above, poor people are more likely to live and work under unhealthy circumstances, for example in areas with increased exposure to natural disasters, such as ones prone to flooding, or to manmade risks such as landmines. Injured people can rarely afford or obtain access to appropriate health services. The absence of timely and adequate health care and rehabilitation causes impairment and long-lasting disabilities. Owing to the nature of their impairment, people with disabilities often spend more on health services than non-disabled persons. This makes them even more vulnerable to poverty. In developing countries there is generally a lack of appropriate health services and rehabilitation measures. Moreover, people who are illiterate or have received less formal education may not know about the possibilities that they could receive from health and rehabilitation services.
Possible solutions
Health-oriented development cooperation addresses three areas in particular: prevention, medical support and rehabilitation (although the latter is also linked to other areas – see next chapter).
The primary prevention of disease and impairment includes vaccinations and also education, especially for mothers. Programmes preventing infectious diseases such as malaria, leprosy, poliomyelitis and HIV/AIDS have to consider their linkages to impairment and disability. Awareness-raising programmes, especially on HIV/AIDS, need to be adjusted so that people with disabilities also have access to this information (e.g. Braille or sign language). Prevention also includes adequate nutrition, especially for children, as malnutrition is one of the main causes of impairment.
National policies should ensure equal access to medical support for people with disabilities. This includes the supply of drugs, surgery or the provision of orthopaedic aids and supporting devices (prostheses, wheelchairs, etc.). However, this can only be ensured if all health services are accessible to people with disabilities, which means not only the physical accessibility of the buildings, but also access to information about possible treatment, risks of drugs, etc.
Medical rehabilitation aims to restore a person’s mental and physical health status.
Example: Tanzanian PRSP
Disability is addressed in the health sector of the Tanzanian PRSP in the following ways:
- “Improve neonatal care and infant care and ensure screening of under 5s for developmental disabilities and target nutrition education and supplementation for undernourished children.”
- “Reduce HIV and AIDS prevalence among woman and men with disabilities (among age group 15-35 years)”
- “Evaluate and critically assess the human resource development strategy in the health sector to identify gaps in skills among health workers and execute a plan for immediate training in key areas, including special health needs of older and disabled persons.”
- “Eliminate all forms of barriers to health care by exempting the poor, pregnant women, older persons and disabled persons, children, and by removing unofficial charges and reduce the distance to, and by improving treatment.”
More information
Ronald Wiman , Einar Helander and Joan Westland (2002): Meeting the Needs of People with Disabilities: New Approaches in the Health Sector. World Bank, Washington, June.
Africa Campaign on Disability and HIV/AIDS: http://www.africacampaign.info/
Suggestions of the WHO Disability and Rehabilitation Team (DAR) on how to include disability in national health policies.
United Republic of Tanzania, Vice President’s Office (2005): National Strategy for Growth and Reduction of Poverty (NSGRP), April.
