Health Equities for Persons with Disability in Pakistan
“Besides the public health issues faced by most of the minority/ vulnerable segment, Persons with disabilities experience additional inequities in health, economic barriers, and difficulties in accessing required care because of their disability. In short, they face a “double burden.”
(US Department of Health and Human Services Advisory Committee on Minority Health, 2011)
Estimated statistics of World Health Organisation shows that more than one billion people live with some form of disability worldwide, out of which approximately 200 million are facing the significant functioning disability. In Pakistan, out of 207 million population (census 2017), some 31 million are estimated to be living with some type of disability in Pakistan. However, due to the lack of a unified definition of impairment at the national level, no extensive national study has been conducted that highlights the actual burden of disability in Pakistan. In addition to the difficulties they face due to inadequate educational attainment and employment opportunities, they also face a significant extra obstacle in the form of health inequities. People with disabilities are two to four times more likely to face health inequities in the form of denied medical care or receiving poor quality health services. The increase in disability is attributed mainly to an ageing population. Although disability is mainly associated with, the ageing population but disability can happen at any age and is not merely a factor of older age. In Pakistan, the government hospitals offers free medical care services for those who are disabled. However, the quality of these health care services is not satisfactory. The health system still lacks to comprehend what disability actually is and this leads to health inequities that are in form of Premature Mortality, Mortality, Morbidity, and Functioning. Unfair or unjust circumstances are the root causes of these disparities. Additionally, barriers to the provision of health service delivery (e.g. transportation, environmental and communication barriers), attitude, capacity, or abilities of the health workforce (like absence of specialized equipment, inaccessibility to necessary medications and assistive technologies), complicated and time-consuming health funding system (e.g. social protection mechanism not considering added costs), lack of knowledge of unique health needs among health providers are also major causes of health disparities. Furthermore, bad governance is a major problem since it leads to ineffective departmental cooperation and lack of participation of PWDs in decision-making process.
Everyone has an equal right to health, including Persons with disabilities and it is the state’s responsibility to respect and protect these rights. However, health equities for persons with disabilities are less discussed topic in Pakistan. Reducing the health disparities for Persons with disabilities result in substantial financial gains that will lead to poverty reduction, reduction in income inequality and access to social protection. These in turn give the most vulnerable members of society the chance to timely and effectively deal with situations of expected uncertainty, like sickness, disability, and unemployment, etc. Therefore, there is need that the health inequities that exist for persons with disabilities should be acknowledge by both policymakers and the government so that effective health care reforms can be set to better serve the needs of this vulnerable segment of the society. It is important to make health equities for persons with disabilities a top health priority in Pakistan and remove access restrictions as well as raise awareness so that they can actively participate in society and make significant contribution in the economy.