Abou-Abbas Linda, Sabbagh Diana, Rossi Rodolfo, Vijayasingham Lavanya, Lteif Maria Rita, Rawi Haya, Mitri Rouba, Al Sultan Hala, Benyaich Aicha, Al-Mosa Ahmad, Truppa Claudia
International Committee of the Red Cross, Lebanon Delegation, Beirut, Lebanon.
American University of Beirut, Beirut, Lebanon.
Int J Equity Health. 2024 Dec 18;23(1):267. doi: 10.1186/s12939-024-02356-4.
Achieving equitable healthcare access for persons with disabilities is vital, as they often face various barriers that impact their health and well-being. Recognizing the importance of gender equity, this study aims to explore the specific barriers faced by women and girls with disabilities in accessing quality healthcare services in Lebanon.
A mixed-method sequential explanatory approach was employed. Initially, a retrospective descriptive study analyzed data from the International Committee of the Red Cross (ICRC)-supported physical rehabilitation programme (PRP) database. Subsequently, in-depth interviews were conducted to delve into factors influencing gender-disproportionate service users and to uncover barriers to accessing healthcare. Levesque et al.'s 'Conceptual framework on healthcare access' was used to organize and map the results.
The quantitative analysis of service utilization at ICRC PRP centers from 2015 to 2022 revealed significant gender disparities, with males comprising 66.6% of service users compared to 33.4% females. This trend was consistent across age categories, nationalities, and clinical conditions. Healthcare access for women and girls with disabilities was found to be inadequate across all five dimensions of the Levesque framework: adequacy, accessibility, affordability, appropriateness, and availability, as well as their corresponding abilities. While certain challenges such as transportation, financial constraints, inadequate infrastructure, and limited information on available services were common to both genders, gender-specific barriers primarily included societal norms, safety concerns during unaccompanied visits to healthcare facilities, limited access to societal information, economic disparities, preferences for female healthcare providers, and the need for privacy during consultations.
This study underscores key barriers hindering healthcare access for women and girls with disabilities in Lebanon, necessitating tailored interventions. Gender-specific challenges, including societal norms and safety concerns, require targeted solutions for improved access and outcomes. This study serves as a call to action for stakeholders at various levels to collaborate and implement concrete measures to bridge the gap in healthcare access and ensure that no one is left behind.
为残疾人提供公平的医疗服务至关重要,因为他们常常面临各种影响其健康和福祉的障碍。认识到性别平等的重要性,本研究旨在探讨黎巴嫩残疾妇女和女童在获得优质医疗服务方面所面临的具体障碍。
采用了混合方法序列解释性研究方法。首先,一项回顾性描述性研究分析了红十字国际委员会(ICRC)支持的物理康复项目(PRP)数据库中的数据。随后,进行了深入访谈,以深入探讨影响服务使用性别不均衡的因素,并揭示获得医疗服务的障碍。使用Levesque等人的“医疗服务可及性概念框架”来组织和梳理研究结果。
对ICRC PRP中心2015年至2022年服务利用情况的定量分析显示,存在显著的性别差异,男性占服务使用者的66.6%,而女性占33.4%。这一趋势在各个年龄组、国籍和临床状况中都是一致的。研究发现,在Levesque框架的所有五个维度(充分性、可及性、可负担性、适宜性和可得性)及其相应能力方面,残疾妇女和女童的医疗服务可及性都不足。虽然某些挑战,如交通、经济限制、基础设施不足以及关于可用服务的信息有限,男女都有,但基于性别的障碍主要包括社会规范、独自前往医疗机构就诊时的安全担忧、获取社会信息的机会有限、经济差距、对女性医疗服务提供者的偏好以及咨询期间对隐私的需求。
本研究强调了阻碍黎巴嫩残疾妇女和女童获得医疗服务的关键障碍,需要采取针对性的干预措施。包括社会规范和安全担忧在内的基于性别的挑战,需要有针对性的解决方案,以改善服务可及性和服务效果。本研究呼吁各级利益相关者采取行动,进行合作并实施具体措施,以弥合医疗服务可及性方面的差距,确保不让任何人掉队。