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A Systematic Review of Access to General Healthcare Services for People with Disabilities in Low and Middle Income Countries

International Centre for Evidence in Disability, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
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Int. J. Environ. Res. Public Health 2018, 15(9), 1879; https://doi.org/10.3390/ijerph15091879
Received: 16 July 2018 / Revised: 17 August 2018 / Accepted: 29 August 2018 / Published: 30 August 2018
(This article belongs to the Special Issue Disability and Global Health)
Background: A systematic review was undertaken to explore access to general healthcare services for people with disabilities in low and middle-income countries (LMICs). Methods: Six electronic databases were searched in February 2017. Studies comparing access to general healthcare services by people with disabilities to those without disabilities from LMICs were included. Eligible measures of healthcare access included: utilisation, coverage, adherence, expenditure, and quality. Studies measuring disability using self-reported or clinical assessments were eligible. Title, abstract and full-text screening and data extraction was undertaken by the two authors. Results: Searches returned 13,048 studies, of which 50 studies were eligible. Studies were predominantly conducted in sub-Saharan Africa (30%), Latin America (24%), and East Asia/Pacific (12%). 74% of studies used cross-sectional designs and the remaining used case-control designs. There was evidence that utilisation of healthcare services was higher for people with disabilities, and healthcare expenditure was higher. There were less consistent differences between people with and without disabilities in other access measures. However, the wide variation in type and measurement of disability, and access outcomes, made comparisons across studies difficult. Conclusions: Developing common metrics for measuring disability and healthcare access will improve the availability of high quality, comparable data, so that healthcare access for people with disabilities can be monitored and improved. View Full-Text
Keywords: access; health care; low and middle income country; LMIC; universal health coverage; people with disabilities access; health care; low and middle income country; LMIC; universal health coverage; people with disabilities
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Bright, T.; Kuper, H. A Systematic Review of Access to General Healthcare Services for People with Disabilities in Low and Middle Income Countries. Int. J. Environ. Res. Public Health 2018, 15, 1879.

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