Disability Inclusive in Public Health Care Services in South Africa: A Change Maker Tool
1
Gender and health research unit, South African Medical Research Unit, Durban, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):A1489
ABSTRACT
BACKGROUND:
People with disabilities have a 20-year shorter life expectancy than their peers without disabilities. Yet, they encounter various attitudinal, physical, and communication barriers when accessing prevention, treatment, care, and judicial services. Healthcare professionals often report a lack of skills and resources to provide inclusive, accessible services.
METHODS:
In 2024 and 2025, we piloted Version 2 of the Disability Awareness Checklist (DAC) with an intervention menu across 24 purposefully selected clinics in KwaZulu-Natal. The DAC comprises 56 elements across four domains: universal design, reasonable accommodation, staff capacity, and care pathway linkages, to assess the clinic's preparedness to serve people with disabilities. Using an appreciative inquiry approach, we evaluated clinics and co-identified solutions with staff. Data were entered into RedCap and analysed using descriptive statistics.
RESULTS:
The DAC assessment revealed significant gaps in disability accommodation and accessibility, with clinics scoring between 29% and 60%. While basic physical features such as ramps and ‘disabled toilets’ were mainly available, other critical elements—including railings, wide doorways, colour contrast, and height-adjustable examination tables were lacking. Information materials and communication strategies did not incorporate accessible formats such as Braille, audio, simple language, or sign language. Additionally, none of the clinic staff had received disability-related training, and essential tools for disability data collection and referral pathways were absent. Staff identified sign language training, accessible information materials, disability education, and screening tools as priority areas for improvement.
CONCLUSIONS:
The DAC process identified both key accessibility gaps and feasible solutions and, therefore, emerged as a promising service assessment tool that can initiate change. Clinic staff prioritised training and improved communication strategies to enhance service accessibility. However, more comprehensive solutions are needed for disability screening, referrals, and monitoring within the intervention menu. Future research should assess the DAC’s impact on service improvements and disability inclusion.
People with disabilities have a 20-year shorter life expectancy than their peers without disabilities. Yet, they encounter various attitudinal, physical, and communication barriers when accessing prevention, treatment, care, and judicial services. Healthcare professionals often report a lack of skills and resources to provide inclusive, accessible services.
METHODS:
In 2024 and 2025, we piloted Version 2 of the Disability Awareness Checklist (DAC) with an intervention menu across 24 purposefully selected clinics in KwaZulu-Natal. The DAC comprises 56 elements across four domains: universal design, reasonable accommodation, staff capacity, and care pathway linkages, to assess the clinic's preparedness to serve people with disabilities. Using an appreciative inquiry approach, we evaluated clinics and co-identified solutions with staff. Data were entered into RedCap and analysed using descriptive statistics.
RESULTS:
The DAC assessment revealed significant gaps in disability accommodation and accessibility, with clinics scoring between 29% and 60%. While basic physical features such as ramps and ‘disabled toilets’ were mainly available, other critical elements—including railings, wide doorways, colour contrast, and height-adjustable examination tables were lacking. Information materials and communication strategies did not incorporate accessible formats such as Braille, audio, simple language, or sign language. Additionally, none of the clinic staff had received disability-related training, and essential tools for disability data collection and referral pathways were absent. Staff identified sign language training, accessible information materials, disability education, and screening tools as priority areas for improvement.
CONCLUSIONS:
The DAC process identified both key accessibility gaps and feasible solutions and, therefore, emerged as a promising service assessment tool that can initiate change. Clinic staff prioritised training and improved communication strategies to enhance service accessibility. However, more comprehensive solutions are needed for disability screening, referrals, and monitoring within the intervention menu. Future research should assess the DAC’s impact on service improvements and disability inclusion.
| eISSN: | 2654-1459 |
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