Ensuring disability inclusive healthcare in Nepal: A qualitative case study in Sindhupalchok District

Abstract

Persons with disabilities often face barriers to accessing healthcare services. Since the ratification of the UN Convention on the Rights of Persons with Disabilities (UNCRPD), Nepal has shown its commitment to disability inclusion in healthcare with several legal and implementational initiatives. The purpose of this qualitative case study was to explore the current situation, experienced challenges, and opportunities of disability-inclusive healthcare at community level in a district of Nepal and to identify the barriers to inclusive healthcare from the perspective of persons with disabilities and the health coordinators of the municipalities. The study applies a qualitative case study design for data collection, analysis, and interpretation. In-depth interviews were conducted with 10 persons with disabilities and with 12 health coordinators in the Sindhupalchok District (one from each municipality) and data collection was supplemented by observations made in four health facilities and by the analysis of plans and policies of the municipalities. Findings reveal that though the challenges of transportation, communication, and inaccessible health facilities persist, the healthcare systems at the local level of Sindhupalchok district are gradually adapting to the needs of persons with disabilities. Moreover, the practice of federalism in the government offers opportunities to mainstream disability in the health sector. However according to the informants, de-prioritization of disability may potentially accompany federalism. It was observed that the formulation of numerous plans and policies at the national and local levels has provided a promising framework for ensuring disability-inclusive healthcare services. Nonetheless, the achievement of this would require federal government's support, guidance, and allocation of resources.