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Can we achieve universal health coverage without a focus on disability? Results from a national case-control study in Guatemala

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Listed:
  • Hannah Kuper
  • Islay Mactaggart
  • Carlos Dionicio
  • Rafael Cañas
  • Jonathan Naber
  • Sarah Polack
Abstract
Objective: To compare access to healthcare services for people with disabilities to those without disabilities, within a national case-control study in Guatemala. Methods: We undertook a population-based case-control study, nested within a national survey in Guatemala. Cases with disabilities were people with self-reported difficulties in functioning. One control without disabilities was selected per case, matched by age, gender and cluster. Information was collected on: health status, access to health services and rehabilitation, and socioeconomic status. Results: The study included 707 people with disabilities, and 465 controls. People with disabilities were more likely to report a serious health problem (aOR 2.8, 2.2–3.7) or doctor-diagnosis of one of 17 general health conditions (aOR 2.9, 2.2–3.8) as compared to controls without disabilities. People with disabilities were twice as likely as controls to have received treatment for a diagnosed condition (aOR 2.2, 1.7–2.8). Coverage of treatment for impairment-related health conditions was low, as was awareness and access to rehabilitation services. People with disabilities were more likely than controls to report being disrespected (aOR 1.9, 1.0–3.7) or finding it difficult to understand information given (aOR 1.6, 1.1–1.4). Conclusion: Efforts are needed to raise awareness about rehabilitation services and improve quality of health services for people with disabilities in Guatemala, to ensure that their rights are fulfilled and to assist in the achievement of Universal Health Coverage. Better tools are needed to measure healthcare access, including consideration of geographic access, quality and affordability, to allow the generation of comparable data on access to healthcare among people with disabilities.

Suggested Citation

  • Hannah Kuper & Islay Mactaggart & Carlos Dionicio & Rafael Cañas & Jonathan Naber & Sarah Polack, 2018. "Can we achieve universal health coverage without a focus on disability? Results from a national case-control study in Guatemala," PLOS ONE, Public Library of Science, vol. 13(12), pages 1-12, December.
    • Handle: RePEc:plo:pone00:0209774
    DOI: 10.1371/journal.pone.0209774
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    References listed on IDEAS

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    1. Arne H Eide & Hasheem Mannan & Mustafa Khogali & Gert van Rooy & Leslie Swartz & Alister Munthali & Karl-Gerhard Hem & Malcolm MacLachlan & Karin Dyrstad, 2015. "Perceived Barriers for Accessing Health Services among Individuals with Disability in Four African Countries," PLOS ONE, Public Library of Science, vol. 10(5), pages 1-13, May.
    2. Hasheem Mannan & Malcolm MacLachlan, 2013. "Disability and Health: A Research Agenda," Social Inclusion, Cogitatio Press, vol. 1(1), pages 37-45.
    3. Rotarou, Elena S. & Sakellariou, Dikaios, 2017. "Neoliberal reforms in health systems and the construction of long-lasting inequalities in health care: A case study from Chile," Health Policy, Elsevier, vol. 121(5), pages 495-503.
    4. Trani, Jean-Francois & Browne, Joyce & Kett, Maria & Bah, Osman & Morlai, Teddy & Bailey, Nicki & Groce, Nora, 2011. "Access to health care, reproductive health and disability: A large scale survey in Sierra Leone," Social Science & Medicine, Elsevier, vol. 73(10), pages 1477-1489.
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