Collaboration for Disability-Inclusive Health Care: Now’s Our Moment

Andrew Tuttle
May 9, 2019 | 4 Minute Read
Gender Equality and Social Inclusion | Disability-Inclusive development | Social Inclusion | Health | Human Resources for Health | Health Workforce Development | Corporate Partnerships
Andrew Tuttle argues that the time is ripe for the development and health sectors in the United Kingdom — and beyond — to partner to advance disability-inclusive health care across the globe.

According to the World Health Organization (WHO), 15 to 20 percent of people globally have a disability and 80 percent of them live in a developing country. This means that more than 900 million people with disabilities live in a low- or middle-income setting. These individuals face a variety of barriers, including restrictive and stigmatizing policies and social norms, that challenge their access and full participation in society. Of note, people with disabilities encounter significant obstacles accessing quality health information and services. As a result, this group often experiences poor health and is vastly underrepresented in the health workforce.

According to the UN Flagship Report on Disability and Development, people with disabilities are:

• Two times more likely to find health-care provider skills and facilities inadequate
• Three times more likely to be denied health care
• Four times more likely to be treated badly in health-care facilities

More than half cannot afford health care at all, and more than half have an unmet need for rehabilitation services to regain lost skills or functions. Achieving the ambitious targets set out in Sustainable Development Goal 3 will never be achieved until health-care systems globally are reformed in such a way that they empower people with disabilities to lead healthy and productive lives.

Achieving the ambitious targets set out in Sustainable Development Goal 3 will never be achieved until health-care systems globally are reformed in such a way that they empower people with disabilities to lead healthy and productive lives.

Suffice it to say, achieving the ambitious targets set out in Sustainable Development Goal 3 (in particular, the achievement of universal health coverage for all with each of its facets of financial protection, quality, and safety) will never be achieved until health-care systems globally are reformed in such a way that they empower people with disabilities to lead healthy and productive lives. So, where do we start? The WHO’s key recommendations for improving health outcomes for people with disabilities include “integrating disability education into undergraduate and continuing education for all health-care professionals” and “providing evidence-based guidelines for assessment and treatment.” These recommendations are fuelled by the significant competency gaps that exist globally around disability-inclusive practices in each cadre of the health workforce — disparities that are by no means limited to the world’s lower-income nations.

Rising Commitment to Disability-Inclusive Health Care

The U.K. Department for International Development (DFID) has shown leadership among global donors by ensuring its official development assistance is as much motivated by equity as it is by cost efficiency. DFID’s new disability inclusion strategy is evidence of its institutional commitment to engage people with disabilities in the creation of donor-funded solutions intended to reduce barriers to participation and the department’s concrete pledge to leave no one behind. In addition to DFID, some U.K.-based health-care organizations have demonstrated a more acute awareness of these disparities and are acting to remedy them. Health Education England, for example, has launched a new disability and inclusion strategy, indicating an emerging public sector trend of mainstreaming disability inclusion in the United Kingdom. With DFID’s rich history of funding partnerships with U.K. health institutions as part of its wider global health development assistance strategy, now seems to be the moment for DFID and its global partners to join forces with U.K. health organizations to develop and test more comprehensive disability-inclusive competency frameworks for the health workforce. They can then work towards tailoring and scaling these efforts to low- and middle-income countries (LMICs) around the globe.

Now seems to be the moment for DFID and its global partners to join forces with U.K. health organizations to develop and test more comprehensive disability-inclusive competency frameworks for the health workforce.

Where Could We Start?

To date, leading U.K. health education institutions have developed in-service trainings for the U.K. health workforce related to social and disability inclusion issues. Skills for Health, for example, a not-for-profit organization committed to the development of an improved and sustainable health-care workforce across the United Kingdom, has developed e-learning courses about disability and mental health awareness to help health and care practitioners in the National Health Service reflect on and improve how they care for people with learning disabilities. Health Education England has developed a train-the-trainer toolkit for a sustainable method of primary care mental health education.

Looking beyond the United Kingdom, Chemonics and its partners have, through the USAID HRH2030 program, been working with national health systems in Africa, Asia, and Latin America to strengthen and develop their health and social service workforces. As part of this work, Chemonics has championed the development of a gender competency framework as a resource for practitioners, health facility staff, trainers, and human resources for health professionals to understand and incorporate gender awareness into core competencies and improve the provision of family planning services. As countries develop their health workforce, health workers’ understanding and awareness of how gender and power dynamics influence the provision of services will foster the skills necessary to provide gender-equitable health care. We could take a similar approach to disability-inclusive health care.

These examples showcase a process for defining and upskilling the health workforce to be more responsive to the needs of its patient population — its whole patient population. A host of resources and trainings exist in various, yet often more advanced, clinical and health education settings around the globe that detail core competencies and strategies for improving disability-inclusive health care. For example, groups like the Alliance for Disability in Health Care Education in the United States and Disability Matters in the United Kingdom have developed core competencies on disability for health care education and e-learning courses on health and well-being for the U.K. workforce, respectively. Our imperative should not be to reinvent these, but to acknowledge the opportunity to build upon them and tailor the best practices within them to the social, behavioral, and clinical realities in the low- and middle-income countries we aim to support.

Seize the Moment

Through partnerships, the health and development sectors could couple the health education platforms and resources in the U.K. health-care sector (and beyond) with the unique challenges and operating environments of LMICs as a basis for developing, testing, adapting, and refining more comprehensive disability-inclusive competency trainings and frameworks for the health workforce. Bringing together more domestically-focused actors with international development practitioners, people with disabilities, and disabled peoples organizations in the communities we serve, there is a real opportunity to pool thinking, refine competency frameworks and tools, and support the global health workforce to better meet the needs of people with disabilities. Now seems like an apt moment for DFID, its partners around the world, and its counterparts in the United Kingdom to advance a truly global health initiative and make meaningful inroads in disability and inclusion efforts.

Posts on the blog represent the views of the authors and do not necessarily represent the views of Chemonics.

About Andrew Tuttle

Based in London, Andrew Tuttle is a public health professional serving as the director of global health in Chemonics’ U.K. Division. For more than 10 years, he has held strategic and leadership roles in project management, monitoring and evaluation, program design and development, advocacy and communications, external relations, and donor resource mobilization in the global…