Health Inequalities in the Global South – barriers in access to healthcare for poor persons with disabilities in Cambodia

Introduction:

The developing world is changing rapidly. Nevertheless, health inequalities exist in all parts of the world, contradict accepted values of human rights and manifest themselves with immediate effect. This case-study analyses the access to public healthcare for poor people with disabilities (PwDs) in Cambodia. The historical past of Cambodia has set former social policy structures to zero. This forces Cambodia to implement new public health policies to align with the needs of social care, healthcare and urban planning. In this context, the role of PwDs is crucial to generate equal access to public healthcare.

Materials & Methods:

This study analyses empirical self-collected data. Four focus group discussions (FGDs) are evaluated. The content is presented in a summarizing matter. In addition, 17 expert interviews were realized. The transcripts of the expert interviews are analyzed using the science-based qualitative content analysis following the methodology of qualitative content analysis by Mayring. Furthermore, national datasets were reviewed for a deeper understanding of the situation of the healthcare system and the living situation of PwDs.

Results:

The social risk group of poor PwDs faces several barriers in accessing public healthcare. These barriers go far beyond a missing ramp to access the healthcare center. The content of the FGDs is ratified and repeated during the 17 expert interviews. All participants of the FGDs faced and continue to face high discrimination, low capacity to work and earn an own income, dependency on others and less social competence. The categories formulated during the analysis led to a generalization of barriers into three main categories: systemic level, individual level and implementation level.

Discussion:

The urbanization, the socio-economic health status, and opportunities for education; all influence social status and have an impact on the health situation of these individuals. Cambodia has various difficulties with providing access to people with disabilities, mostly due to barriers regarding finances, geography, quality of care, poor knowledge about the rights of PwDs themselves and negative rumors about treatment experiences at a healthcare center.

Conclusion:

The case-study of Cambodia discussed a problem and categorized a variety of barriers in accessing public healthcare for a social risk group in a country in the Global South. This phenomenon can be adapted to situations in other countries.