Health system access challenges of people with disabilities increased during Covid-19 pandemic.

BACKGROUND: People with disabilities (PWDs) have unequal access to health services compared with the general population and this disparity is worsening during the Covid-19 pandemic. Evidence supports the importance of policy development and legislation for addressing the unmet health needs of PWDs, but little is known about the impact of these efforts in Ghana. OBJECTIVE: This study examined health system experiences of PWDs in Ghana within the context of existing disability legislation and related policies prior to and during the Covid-19 pandemic. METHODS: Narrative analysis of data from qualitative research approaches of focus group discussions, semi-structured interviews, and participant observations were used to examine the experiences of fifty-five PWDs, four staff of the Department of Social Welfare, and six leaders of disability-focused non-governmental organizations in Ghana. RESULTS: Structural and system barriers hinder PWDs access to health services. Bureaucratic bottlenecks hinder PWDs access to Ghana's free health insurance policy and health workers' disability stigma impedes accessibility to health services. CONCLUSIONS: Access barriers and disability stigma increased accessibility challenges for PWDs in Ghana's health system during the Covid-19 pandemic. My findings support the need for increased efforts toward making Ghana's health system more accessible to address health disparities experienced by PWDs.

Inclusion team science improves participation of children with disabilities in pediatric obesity programs.

BACKGROUND: Children with disabilities have higher prevalence rates of obesity compared to children without disabilities. Evidence supports the importance of early interventions in preventing pediatric obesity from progressing to adulthood obesity but there are limited opportunities for children with disabilities to participate in these early life programs. OBJECTIVE: The aim of this study was to examine multiple frameworks of disability inclusion that progressively reshaped an existing pediatric obesity intervention program toward improving participation for children with disabilities. METHODS: A qualitative narrative analysis approach involving semi-structured interviews, focus groups and participant observations was used to describe the experiences of eight obese children with disabilities, twelve obese children without disabilities, ten parents and ten volunteer healthcare student trainers who participated in an obesity intervention program, Fit Kids for Life (FKFL). RESULTS: FKFL participants' positive worldviews of disability inclusion, active involvement of parents and family members, diverse team of health professionals and volunteers, and improved health outcomes facilitated children with disabilities' participation in the program. Disability and obesity stigma and lack of local inclusive sites hindered access and participation for children with disabilities. CONCLUSIONS: Results support using inclusion team science to improve participation and outcomes of a pediatric obesity intervention program for children with disabilities.