Health worker training often lacks disability-related skills, information, and sensitivity. For example, a review found that only 8% of Western Pacific countries included disability-related information in healthcare undergraduate training. 

Health workers' Lack of Skill

People with disabilities are usually poorer and have higher healthcare costs. The World Report on Disability found that half of people with disabilities cannot afford healthcare, and they are 50% more likely to face really high health costs. Many people with disabilities also find it hard to get to healthcare because transport costs are a big problem.

Healthcare Needs To Be More Affordable

The world is experiencing a severe shortage of rehabilitation workers, such as physical therapists, mental health professionals, occupational therapists, speech-language pathologists, and prosthetic and orthotic practitioners. This problem is most severe in lower-income countries. For example, sub-Saharan Africa has only six specialized rehabilitation physicians, and many Southeast Asian countries have fewer than ten physiotherapists per million people.

Shortage of Healthcare Specialists


Healthcare facilities, including buildings, rooms, equipment, and toilets, often have limited physical accessibility. A Florida survey showed that people with disabilities were 5-10 times more likely to encounter physical barriers to access and communication challenges. 

Limited Infrastructure

Many ministries lack a department or staff dedicated to disability or rehabilitation. Twenty percent of WHO’s WPRO region countries had no disability-related capacity within the Ministry of Health.

Poor Management and Leadership

- Healthcare needs to be more affordable
- Health workers' lack of skill
- Shortage of healthcare specialists
- Limited infrastructure
- Poor management and leadership

Portland State University

Around the world, one billion people live with disabilities. This report argues that these individuals are being left behind regarding health. Lack of access not only goes against the rights of people with disabilities under international law but also poses a challenge to achieving better health services for one billion people with disabilities, which is essential for achieving Universal Health Coverage (UHC) and Sustainable Development Goal 3. Most of these individuals are in low and middle-income countries and the poorest sections of society. People with disabilities encounter more obstacles in obtaining healthcare services and have less health coverage, leading to poorer health outcomes due to their higher healthcare needs.

Access to Healthcare

Kuper, H, Heydt, P. (2019). The mission billion: access to health services for 1 billion people with disabilities. London School of Hygiene & Tropical Medicine, 2019. https://www.lshtm.ac.uk/TheMissingBillion

Access To Health Services For 1 Billion People With Disabilities

- Global policymakers
- Governments 
- Funders
- Implementers and Advocates

Recommendation for Stakeholders to Make Health Service More Accessible for People with Disability

Common Barriers for People with Disabilities When Accessing Healthcare


- Pre-term births 
- Stillbirths 
- Malnourished
- Severe diarrhea 
- Serious illness
- HIV prevalence 
- Diabetes 
- Cardiovascular 
- Suicidal ideation
- Substances
- Reversible contraceptives 
- Access health services 
- Healthcare provider’s skills
- Healthcare expenditures
- Environmental risks

Health Gaps Experienced by People with Disability versus Normal People

- Achieving Sustainable Development Goals (SDG 3) and Universal Health Care (UHC) goals 
- Complying with international law
- Improving health services for all through universal design
- Preventing unnecessary cost for the health system
- Achieving all SDGs

Addressing the Health Gaps is Critical for Several Reasons

- Anesu from South Africa
- Dustin from the USA
- Morowa from Ghana
- Simon & Tuwafu from Malawi
- Sylvia & Maria from Brazil

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