Inclusion of people with disabilities in Chilean health policy: a policy analysis

Author:

Gatta Danae Rodríguez1,Monclus Pamela Gutiérrez2,Wilbur Jane1,Hanefeld Johanna3,Banks Lena Morgon1,Kuper Hannah1

Affiliation:

1. London School of Hygiene & Tropical Medicine

2. University of Chile

3. Robert Koch Institute

Abstract

Abstract

Background Around 18% of the population in Chile has disabilities. Evidence shows that this population has greater healthcare needs, yet they face barriers to accessing healthcare due to health system failures. This paper aims to assess the inclusion of people with disabilities in health policy documents and to explore the perceptions of key national stakeholders regarding the policy context, policy processes, and actors involved. Methods A policy content analysis was conducted of 12 health policy documents using the EquiFrame framework, adapted to assess disability inclusion. Documents were reviewed and rated on their quality of commitment against 21 core concepts of human rights in the framework. Key national stakeholders (n = 15) were interviewed, and data were thematically analysed under the Walt and Gilson Policy Analysis Triangle, using NVivo R1. Results Core human rights concepts of disability were mentioned at least once in nearly all health policy documents (92%). However, 50% had poor policy commitments for disability. Across policies, Prevention of health conditions was the main human rights concept reflected, while Privacy of information was the least referenced concept. Participants described a fragmented disability movement and health policy, related to a dominant biomedical model of disability. It appeared that disability was not prioritized in the health policy agenda, due to ineffective mainstreaming of disability by the Government and the limited influence and engagement of civil society in policy processes. Moreover, the limited existing policy framework on disability inclusion is not being implemented effectively. This implementation gap was attributed to lack of financing, leadership, and human resources, coupled with low monitoring of disability inclusion. Conclusions Improvements are needed in both the development and implementation of disability-inclusive health policies in Chile, to support the achievement of the right to healthcare for people with disabilities and ensuring that the health system truly “leaves no one behind”.

Publisher

Springer Science and Business Media LLC

Reference46 articles.

1. World Health Organization. Global report on health equity for persons with disabilities [Internet]. Geneva. 2022. https://www.who.int/publications/i/item/9789240063600.

2. United Nations. Convention on the Rights of Persons with Disabilities—Articles. [Internet]. 2006. https://www.un.org/development/desa/disabilities/convention-on-the-rights-of-persons-with-disabilities/convention-on-the-rights-of-persons-with-disabilities-2.html.

3. The association between disability and mortality: a mixed-methods study;Kuper H;Lancet Public Health,2024

4. García Mora ME, Schwartz Orellana S, Freire G. Disability Inclusion in Latin America and the Caribbean: A Path to Sustainable Development [Internet]. Washington, DC; 2021. https://documents1.worldbank.org/curated/en/099015112012126833/pdf/P17538305622600c00bf3f09659df1f2f79.pdf.

5. Access to general health care among people with disabilities in Latin America and the Caribbean: a systematic review of quantitative research;Rodríguez Gatta D;Lancet Reg Health - Americas,2024

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