Hesperian Health Guides
Making health services easier to use
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Together disabled women and health workers can make health services better serve women with disabilities. They can find ways to make it easier for women with disabilities to get into a health center, to use the equipment, to increase knowledge about disabilities, and to improve the attitudes of health workers towards disabled women. Most of these changes are not difficult or expensive to do.
These changes will also help many others, such as older people who do not move as easily as when they were young, or anyone who has had an accident and is temporarily disabled with a broken leg or arm.
Ideas to make health services more disability-friendly
- Offer weekly or monthly home visits to people who live far from health centers.
- Offer free health services for women with disabilities.
- Make equipment easy to use.
- Provide public or private transportation to the health center. Transport must be easy to use for people who use wheelchairs, crutches, or have difficulty walking.
To learn more about access, see Other Resources.
Barriers to health care
- For a woman using a wheelchair or crutches, most health centers and hospitals are difficult to get to. They are often far away and there is no transport a woman with a disability can easily use to get there.
- Equipment and supplies, such as lower beds or good quality catheters, are often not available.
- The hours the health center is open may not be convenient.
- There may be few women doctors even though many women feel embarrassed to go to a male doctor.
- Health workers do not know how to communicate with someone who is deaf, and there are no health information materials for women who are blind.
- Health care workers, including nurses and doctors, may not be very well trained, or may not know much about disability. They may have wrong ideas about disability and may not listen to you.
- Health services can be expensive and you may have to bribe someone before you can meet with a health worker (corruption).
Suggestions to make clinics and hospitals easier to use
Clinics or hospitals must:
- be nearby and there must be transport available to reach them.
- be easy to use for people who use wheelchairs or crutches, or have difficulty walking.
- have ramps or lifts as well as stairs.
- have toilets that disabled women can use.
Clinics and hospitals must also have trained staff members who can communicate effectively with people who are deaf or blind, or who have cerebral palsy, and who can make sure that women who have learning difficulties understand what is happening in the clinic.
Clinics and hospitals can:
- train everyone about disability.
- include women with disabilities as health workers and staff members in clinics and hospitals.
- put handrails or ropes around the building so that people who are blind or do not see well can find their way inside safely.
- organize activities about health and women with disabilities.
- provide monthly or regular counseling sessions for women with disabilities.
- make it easy for women with disabilities to combine as many appointments in different departments as necessary during the same day they go to the clinic or hospital. Some health centers allow village health workers to make these appointments for women with disabilities.
- make information on how to use health services easy to obtain and understand.
- provide health information in different languages.
- provide blind women with health information in Braille or on audio cassettes.
- encourage health workers to use simple, clear language and pictures to illustrate what they are saying to women who have trouble learning or understanding.
- train health workers to communicate with women who have problems with speaking clearly.
- train staff members in sign language so they can give health information to deaf women.
A clinic will be easier for deaf women to use if even one health worker knows the sign language used among deaf people who live in that community. If there are no formal sign language classes close to the clinic, perhaps a clinic worker can learn sign language from the national deaf association, or learn sign language from a deaf person who lives nearby. They can also use a local sign language dictionary if one is available. Even without using formal sign language, health workers can use gestures to communicate. Deaf women themselves will be the best people to tell health workers the type of communication that works best for them.
See Appendix B: Sign language for health.
Community health workers can provide care
In many countries, the skills needed to care for disabled women are considered special and provided only by doctors. Yet many of these services could be provided at lower cost by trained community health workers, teachers, and rehabilitation workers.
Bringing services to disabled children
Field workers from the Hospital and Rehabilitation Centre for Disabled Children in Kavre, Nepal support disabled children throughout Nepal. These trained field workers provide disabled children with treatment for their pressure sores, and provide physical therapy and exercises to strengthen affected muscles and prevent contractures. Field workers also provide aids so the children can move about in their communities more easily.
For more information about community-based support for people with disabilities, see Disabled Village Children.