Non-use of healthcare services among persons with mobility impairments in Cofimvaba, South Africa.

Background: Access to primary health care is a fundamental right for all. However, persons with disabilities are experiencing difficulties when accessing healthcare because of various environmental and personal barriers which may lead to nonuse of such services. Objectives: This study aimed to identify the challenges leading to non-use of healthcare services among persons with mobility impairments in Cofimvaba. Method: A descriptive qualitative design using snowball sampling was implemented. Semistructured interviews were conducted in isiXhosa with five participants who stopped accessing healthcare, using a self-developed interview guide. Inductive thematic analysis was used to develop codes and themes from the data. Results: Study findings revealed major challenges experienced by persons with mobility impairments in accessing healthcare. These included inaccessible roads, geographic inaccessibility, financial accessibility and indirect cost of care, having little or not many health problems, physical infrastructure difficulties within facilities, and attitudinal barriers. Conclusion: The findings indicated that persons with disabilities are experiencing a combination of structural and environmental challenges which make them stop accessing healthcare. Contribution: The article shares insights on access challenges that influence non-use of the often-needed healthcare services within the context of rural areas.

Challenges and opportunities of centring the African voice in disability research.

In 2020, the African Network of Evidence to Action on Disability (also known as AFRINEAD) hosted its 10th conference in Cape Town. This paper synthesises inputs by the three authors as plenary addresses, particularly focusing on the challenges and opportunities of centring African voices in disability research. Our concern in this article is to engage with the question of exclusion as an issue not just in the everyday lives of people with disabilities but also in the world of ideas - the ideational space. We suggest that a reimagined disability study depends on the centring of African experiences, voices and knowledges. This is especially so as there are African concepts that are not rigorously pursued in research. African Renaissance thinking makes allowance not only for critically reflecting on the historical and contemporary constructs of disability but also for fashioning a higher civilisation in which people with disabilities can exist within society as worthy and valued human beings.

Experiences of Organisations of (or That Serve) Persons with Disabilities during the COVID-19 Pandemic and National Lockdown Period in South Africa.

Organisations have long played an effective role in advocating for and actioning crucial developmental and humanitarian functions around the world, often under challenging conditions, as well as servicing the health needs of persons with disabilities. This article reports on the experiences of organisations of (or that serve) persons with disabilities, hereafter called service providers, during the COVID-19 lockdown period in South Africa beginning 26 March 2020. Organisations participated in an online survey as well as virtual narrative interviews to voice out their experiences. Five major themes emerged: (1) difficulties in keeping the doors open; (2) continued care under lockdown; (3) restructuring of care (4) government systems and policies; and (5) reaching out to offer and receive support. The findings demonstrate that the South African government failed to ensure targeted support to organisations of persons with disabilities. A remarkable feature of the organisations we interviewed for this small study was their agility in responding creatively to the challenges they faced, despite the difficulties. There is a need for government support to include targeted efforts to support organisation of persons with disabilities during pandemics to avoid worsening service gaps.

COVID-19 pandemic and disability: essential considerations

People with disabilities have greater healthcare needs and are more likely to experience poor health, however, their access to healthcare remains compromised compared to people without disabilities. Despite this well recognised need, people with disabilities often face barriers to accessing healthcare and they face additional risks to their well-being, because of the ongoing COVID-19 pandemic. In this paper, we posit that people with disabilities are vulnerable in the context of the COVID-19 pandemic. We demonstrate this vulnerability through briefly highlighting eight key considerations, as they relate to disability and COVID-19. We conclude that both inaccessible healthcare systems and the presence of underlying health conditions put people with disabilities at additional risk. Further, vulnerability to severe illness and death, post-contracting COVID-19, is exacerbated by the interaction between impairments and personal and environmental barriers existing at different levels, resulting in a disproportionately negative impact for people with disabilities. It is thus not sufficient to look only at underlying medical conditions as an indicator of risk for contracting COVID-19. Additionally, the challenge posed by not routinely collecting data on disability renders potential difficulties in linking disability to COVID-19 deaths/infections. More research is needed on disability and COVID-19 to inform disability-inclusive pandemic responses.