ACCESS TO HEALTHCARE FOR CHILDREN WITH DISABILITIES IN THE GREATER ACCRA REGION

ABSTRACT

Background and Objectives: People with disabilities have special healthcare needs that usually remain unmet. Studies have identified barriers encountered by people with disabilities in accessing healthcare. This study was aimed at identifying factors that both facilitate and hinder access to healthcare for children with disabilities [with focus on Autism, cerebral palsy (CP) and Down syndrome (DS)] in the Greater Accra region of Ghana.

Method: The study employed a cross sectional study design and it used a mixed method approach; involving quantitative and qualitative methods. The quantitative component involved administration of semi-structured questionnaires to parents/caregivers of children with Autism, CP and DS in seven (7) special schools in the Greater Accra Region. The qualitative component involved the use of in-depth interviews with parents/caregivers of children with Autism, CP and DS and key informant interviews with specialist healthcare providers.

Results: Results of a one-way analysis of variance showed that mean access score was significantly different for categories of educational level [F (2, 35) =5.79, p=0.0067] and household income range [F (2, 35) = 5.94, p=0.0060]. Children who attended private schools had a higher mean access score [difference (S.E) = 14.03% (4.62)] compared to those who attended public school, Welch's t-test, t (16.7) = 3.0372, p=0.0075. Qualitative results identified influential health service factors as: availability of specialist healthcare provider; availability of disability friendly structures; attitude of healthcare providers; lack of coordination of care; and inappropriate service delivery processes. Individual factors influencing access were found to be cost of affording services/medications, and perception of Child's condition. Other factors identified qualitatively were; social factors such as stigmatization and factors related to the child's condition.

Conclusion: Findings from this study highlights challenges related to both access and utilization of needed healthcare services for children with disabilities. Improving access to healthcare services would thus involve a coordinated, concerted and deliberate effort on the part of the government, parents and all stakeholders involved in care for children with autism, cerebral palsy, and Down syndrome.