Rights and requirements of people with disabilities are neglected while planning, designing and building different healthcare facilities, leaving them unable to access the services available, amplifying their vulnerability, and negatively affecting health and wellbeing.
Some of the major barriers to accessing healthcare services for people living with disabilities include:
The Centre of Excellence for Gender, Sexual and Reproductive Health and Rights at BRAC James P Grant School of Public Health, BRAC University carried out a nationwide research with financial support from the Royal Embassy of the Kingdom of Netherlands. The study documented sexual and reproductive health experiences and service challenges through a survey among 5,000 people with disabilities, covering all 12 types of disabilities as mentioned in Persons with Disabilities Rights and Protection Act 2013. In addition, 51 ethnographic case studies, 45 key informant interviews and 18 health facilities were visited to get an in-depth understanding of these aspects.
The agreement on accessibility
Bangladesh is a signatory body of the United Nations’ Convention on Rights for Persons with Disability, and is therefore obligated to provide equal access to healthcare, including sexual and reproductive health for people with disabilities. Article 25 of the convention states, “Persons with disabilities have the right to access healthcare without discrimination on the basis of disability”. The Sustainable Development Goals also stress on improving access to healthcare infrastructure for all through universal health coverage.
Bangladesh’s Persons with Disabilities’ Rights and Protection Act 2013 defines ‘accessibility’ aligned with the CRPD, which includes physical accessibility into all premises, and unrestricted access to services, information, and any form of communication.
Bangladesh National Building Code 2008 (BNBC) contains regulations for disability-friendly construction and is working towards ensuring minimum standards for making buildings accessible.
The reality of accessibility: What the study found
Despite the regulations in place, a majority of the healthcare facilities visited under the study were found to be inaccessible due to implementation challenges.
Only the tertiary healthcare facilities have separate waiting areas with proper seating arrangements, separate billing counters to prioritise persons with disabilities.
Simple initiatives can be taken to mitigate some of these major challenges:
Finally, design and construction of health facilities and other basic services need to be brought into discussion in engagement with people living with disabilities, across gender, age and diverse types of disability. A coordinated approach from relevant ministries, stakeholders and disability experts can fill some of these key gaps to achieve government’s priority areas. In consequence, we will be on track to achieving the Sustainable Development Goal of building a participatory and inclusive society where people with disabilities can live with dignity.
Adrita Kaiser is an assistant coordinator, BRAC James P Grant School of Public Health. Nigar Sultana Zoha is an intern, BRAC James P Grant School of Public Health. The authors would like to thank Dr Tanvir Hasan, associate professor and principal investigator of the research project and Dr Sabina Faiz Rashid, dean and professor of BRAC James P Grant School of Public Health, for their valuable support.