Zahika Shah MSc. Global Health Bachelors in Medicine and Surgery Inclusion of People with Disabilities in the Healthcare Policies in Malawi Zahika Shah MSc. Global Health Bachelors in Medicine and Surgery

Disability Models Charity Medical Medium Term Social Human Rights Theoretical underpinning of disability Charity Medical Medium Term Social Human Rights Something that a person is “afflicted with” Condom Catheters 1 day Health condition Social construct Human rights deficit Recipient of care, treatment or protection Requirement of only medical intervention Indication: Urinary Incontinence Mainstreaming and inclusion Equal opportunities and participation Intermittent Catheters 4-5 Times a day Indwelling Catheter Upto 3 months Condom Catheters 1 day Indwelling Catheter Upto 3 months Suprapubic Catheter Upto 2 months

Practical Approaches to Disability Disability Specific Approach Disability Sensitive Approach Twin Track Approach Making PWD concerns and experiences an integral part of policy-making Mainstreaming disability into every other sector Twin track approach to reduce inequities Recommended approach Interventions for addressing specific needs of PWDs Medical interventions to target a specific impairment Adaptive devices like wheelchairs or hearing aids

Agenda 2030 Leave no one behind Milestones in the Inclusion of PWDs Adopted in December 2006 Ratified by 177 countries Agenda 2030 Leave no one behind Agenda 2030- Leave No one Behind Agenda 2030 - Leave no one behind

3 Ratification of UNCRPD, 2007 Disability in Malawi 2 Recognition of Disability Rights by the constitution, 1994. 4 Disability Act, 2012 1 Establishment of MACOHA, 1971 3 Ratification of UNCRPD, 2007

Healthcare policies in Malawi Essential Health Package (2004) Cost effective interventions free of cost at the point of delivery Health Sector Strategic Plan II (HSSP II) (2017-2022) For provision of equitable health services National Community Health Strategy (NCHS) (2017-2022) Improving the livelihood of people of Malawi by their active participation in all the steps of service provision

Stakeholder Involvement Methodology Qualitative Grounded Theory Approach Key informant interviews Focus group discussions Stakeholder Involvement Qualitative Research

Focus Group Discussion Setting Photos used with consent

Factors Undermining Inclusion in Healthcare Policies

Quotes from the Interviews … The major challenge that we usually face is to queue, we wait in the queue for a long time. Because I can’t see…” PWD1, FGD1 Most of them (blinds) say that we have to queue up, but that’s just a story” Health Ministry ...so we are talking about provision of either hearing aids or cochlear implants instead of saying that lets bring a sign interpreter. Because that’s not the solution for the patient. The solution for the patient is make them hear.” Health Ministry

Recommendations From theory to action Sensitization and training of policy makers To ensure inclusive frame of mind during policy formulation Review and Analysis of existing laws and policies For disability inclusion Extensive and timely involvement of Stakeholders To address the needs of PWDs through expertise and experience Adoption of Twin Track Approach Disability specific programs & Mainstreaming disability Modifications in the curricula of health workers Integrate disability sensitization and basic sign language training Identification of all PWDs Provision of special cards to all PWDs in order to recognize their needs.

Thank You ! Monkey Bay, Lake Malawi