Health system access challenges of people with disabilities increased during Covid-19 pandemic.
Chris-Mike Agbelie
PMID 36804186WHAT IT FOUND
People with disabilities in Ghana reported worsening barriers to care during the pandemic, including unaffordable transport, insurance bureaucracy, and stigma.
Therapists should anticipate that economic hardship and fear of discrimination may cause patients to miss appointments or abandon rehabilitation.
Key findings
01Participants reported that the cost of physical therapy and transportation caused them to quit rehabilitation despite making progress.
02Bureaucratic delays and changes to the free health insurance enrollment process prevented some participants from accessing services or led to unpaid hospital bills.
03Participants described encountering derogatory attitudes from health workers, which reduced their confidence in receiving adequate care.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study used purposive convenience sampling, so the findings may not be generalizable to all people with disabilities in Ghana or other regions. People with cognitive impairments were excluded from the study, limiting the understanding of their specific experiences. The analysis aggregated findings across different impairment types and genders because no significant differences were found, which may mask unique challenges faced by specific subgroups. The researcher's positionality as a person without disability who lived outside the country required negotiation of access, which may have influenced the depth of trust and data collected.
Declared interests
The research was supported by non-U.S. government funding. The author declared no conflicts of interest.
The easy way to misread this
Do not assume that patients who miss therapy appointments are non-compliant. The study shows that structural barriers like unaffordable transport and insurance bureaucracy, rather than patient attitude, were the primary reasons for disengagement.