Disparities in physical access and healthcare utilization among adults with and without disabilities in South Africa

Background

In South Africa barriers to accessing health services by persons with a disability would appear to be exacerbated by the overburdened state of public healthcare.

Objectives

/Hypotheses: The study examined physical access to and utilization of healthcare services by persons with and without a disability. It was hypothesized (1) that households with disabled members were less likely than households with non-disabled members to have good physical access to healthcare; and (2) households with disabled members were less likely to have visited a health facility in the preceding 12 months.

Method

A secondary analysis of adult data from the South African General Household Survey (GHS) (2014) was conducted. Data were analysed using the Stata statistical programme. Analyses included frequencies and percentages, X² tests of association and Cramer's V.

Results

Findings from the individual level of data analysis indicated that 11% of adults were people with a disability with the most common disability being seeing difficulties. Households with disabled members were more likely to have poorer physical accessibility to healthcare in terms of having no medical aid, using public healthcare facilities, walking to the health facility and taking longer travelling time compared with non-disabled households (p=<0.05), thereby confirming hypothesis 1. Despite having poorer physical access, households with disabled members were more likely to have visited a health facility during the preceding 12 months (p=<0.05), thereby rejecting hypothesis 2.

Conclusions

These findings highlight inequities in physical accessibility to healthcare and the need for National Health Insurance for all citizens.