Breaking the systemic discrimination and stigma persons of disability endure in our primary healthcare system

Today, an estimated 1.3 billion people (or 1 in 6 people) worldwide experience significant disability according to a 2023 report of the World Health Organization (WHO).

The 2021 Ghana Population and Housing Census report that persons with disabilities (PWDs) in Ghana is significantly high – over 2million (that is 8% of the country’s population of over 30million (Ghana Statistical Service, 2021).

Sadly, PWDs die earlier, have poorer health, and experience more limitations in everyday functioning than the rest of the population due to health inequities.

This is critical because, research evidence shows that, PWDs have twice the risk of developing non-communication diseases (NCD) and other conditions such as depression, asthma, diabetes, stroke, obesity or poor oral health (WHO, 2023).

It is critical to note that these 2million PWDs figure is not just some mere statistical computation to read and move on by you or as a nation!

These PWDs are real human beings like you, your wife, husband, sisters, brothers and even your sons and daughters who most of them through no fault of theirs, usually through accidents or birth defect or natural disaster developed disabilities.

Never forget that, this can be you, the very reason you and I must care and call on the Government of Ghana through the Ministry of Health to prioritize the health of PWDs in our primary healthcare system especially in deprived and vulnerable rural communities by developing and implementing a national Standard Operating Procedures (SOPs) on Inclusive Health Service Delivery for PWDs to safeguard their rights to health guaranteed by the Article 29 of the 1992 Constitution of Ghana.

Youth Rise International (YoRI) is a youth-led grassroots and advocacy organization that mobilizes and empowers vulnerable youth and deprived rural communities to fights the roots causes and intersection of extreme poverty, climate change and health disparities in Africa.

Today, we have impacted the lives of over 650,000 vulnerable populations with specific focus on marginalized youth, high risk pregnant women and adolescent girls and person with disability. One of our recent flagship initiative is RIGHTS TO HEALTH FOR PWDs advocacy campaign.

In developing this campaign, we deeply consulted key stakeholders at the grassroots with specific reference to vulnerable PWDs in rural communities in Ghana.

Our passion and resolve to advance the cause of ensuring that every PWD in Ghana enjoys their rights to health jumped to the roof hearing troubling stories such as: “The disparities between differently able persons, that is persons with disability is very wide and it is very obvious. When it comes to access to healthcare, it is becoming very challenging owing to the fact that, for instance persons with hearing impairment are not able to communicate with health professionals making it difficult to access some healthcare facilities.

So, for instance, when someone [PWD] is suffering from stomach ulcer, and goes to the hospital to complain to the nurse, this is my condition because of communication misunderstanding [gap], it becomes challenging for health professionals to give the right diagnosis for the hearing impaired individuals “said a FGDs participants who is an active member of Ghana National Association of the Deaf (GNAD).

Nevertheless, it is an established fact that disability inclusion is critical to achieving the Sustainable Development Goals (SDGs) and global health priorities captured in the Universal Health Coverage (UHC) Agenda which Ghana has subscribed to and made solemn commitment towards its implementation.

Nevertheless, if urgent steps are not taken by the Ministry of Health and Ministry for Gender, Children and Social Protection to address this health injustice that over 2million PWDs in Ghana fight daily within our primary healthcare systems, Ghana will not be able to meet the health targets of the UHC and SDGs which has serious implication on our international reputation and partnership with international development partner (WHO, 2023).

Institutional Frameworks and Government Response For PWDs: Youth Rise International (YoRI) and its local partners on this campaign such as Women In Distress Africa (WiDA) and CAMPAIGN Africa recognize the effort and work done by current and successive government in ensuring the protection of the rights of PWDs in Ghana.

Legally speaking, apart from Article 29 of the 1992 Constituent of Ghana which makes clears provisions for the protection of the rights of PWDs, the Children’s Act, 1998 (Act 560) clearly makes provisions for protection of children with disabilities.

This same acts mandated the Department of Social Welfare (DSW) at the local government level to oversee the protection of all PWDs in Ghana. In fact, Youth Rise International (YoRI) is thrilled about how PWDs were prioritized as one of the key beneficiaries of Ghana’s flagship cash transfer programme, the Livelihood Empowerment Against Poverty (LEAP).

We deeply recognize that despite some challenges the LEAP programme has faced such as issues around targeting and delay in the release of funds especially during the COVID-19 era, its impacts on the welfare and protection of PWDs has been incredible.

Additionally, the passing of the Persons with Disability Act, 2006 (Act 715), further strengthen the legal framework spaces especially with clear provisions towards DSW and the Ministry of Health.

For instance, Section 32 of the PWD Act, 2006 (Act 715) clearly stipulates that “The Ministry of Health shall include the study of disability and disability related issues in the curricula of training institutions for health professionals to develop appropriate human resource to provide general and specialized rehabilitation services while Section 33 of the same Act stipulates that “The Ministry of Health shall include education on disability and disability issues in healthcare programmes.”.

These are such great provisions and we are of the candid view that if these laws are enforced and policy provisions are implemented as stipulated, Ghana should be one of the best PWDs rights protection hub in Africa.

THE CRITICAL GAP AND POLICY RECOMMENDATIONS: A critical policy gap identified by our PWDs community in Ghana is the lack of SOPs within our primary healthcare system. Due to this, today, these 2million minority group faces significant stigma, discrimination and poor customer handling by healthcare professionals.

For instance, participants form our community engagements with PWDs highlighted the systemic stigma and discrimination they endure within our primary healthcare system as though they are second class citizens or less human.

But the good news is that once the SOP is developed and operationalized, it will become imperative for the Ministry of Health and Ghana Health Service to ensure that every health facility in Ghana will have dedicated health workers who are trained and skilled in sign language interpretation as well as specialized ability to handle PWDs who come to our health facilities to access healthcare.

Having and implementing the SOPs enforcing the Persons With Disability Acts, 2006 (Act 715) will guarantee the rights to health for all PWDs in Ghana.