Challenges Ahead

The main strength in health-care provision for persons with physical disabilities lies in free medical insurance whereby, under the law, all persons with disabilities are granted access to services in the public health system. However, the statistics provided in table 4 show that only 58.5 per cent of persons with physical disabilities have a health insurance. Policymakers need to determine the causes of this discrepancy. The relatively low number of insured persons with disabilities could result, for example, from a lack of awareness of the existence of free medical insurance. It could also derive from administrative constraints or from the definition of persons with disabilities used to determine the eligibility of individuals to free medical insurance. 

In general, persons with physical disabilities face two major challenges with regard to accessibility and adaptability of health-care services, namely: limited physical accessibility to health services; and inadequate mainstreaming of persons with physical disabilities in the health-care system.

The National Disability Strategy fails to mention the need to alter physically the environment and enhance accessibility to health infrastructures. There is no available information on the number of physically accessible institutions that operate under the Ministry of Health or the number of beneficiaries who have physical disabilities. In general, field visits have shown that scarce, if any, efforts have been made to render hospitals or diagnostic centres accessible.

Persons with disabilities complain about their access to mainstream medical staff being restricted owing to the requirement whereby they must first consult the doctor in charge of disability diagnostics irrespective of the nature of the health concerns for which they seek medical assistance. In addition, the main concern of the Ministry of Health for persons with disabilities seems to revolve around providing health services in the areas specific to disability, including, for instance, diagnosis of disability, provision of specialized equipment and rehabilitation. 

More effort by the Ministry seems to be needed in order to ensure unrestricted access of persons with disabilities to the mainstream health-care system. In that regard, the Ministry needs to coordinate efforts with the relevant municipalities in order to ensure the physical accessibility of health-care centres. It must also ensure that the procedures of health-care services provision to persons with disabilities are not discriminatory and can provide the best quality available to cater for their needs. 

More generally, the needs of persons with disabilities must be integrated in the Public Health Law and the coordination between different institutions and stakeholders needs to be enhanced.

On the whole, in addition to limited accessibility, efforts to mainstream the needs of persons with physical disabilities in the health-care system remain inadequate and issues of non-discrimination and adaptability of mainstream services need more attention. These limitations point to the prevalence of the “medical model” in dealing with persons with disabilities in the health sector over the “social model”. Indeed, policymakers have until now focused on providing specific medical services for persons with disabilities. There is a need to deal adequately with the social, environmental and administrative barriers that prevent persons with disabilities from receiving treatment within the mainstream health-care system and fully enjoying their right to health care.