Stakeholders’ perspectives on a pilot project focusing on improving access to primary healthcare for adults with disability in Santiago Atitlán, Guatemala

Abstract

Background: Primary healthcare has been identified as a key strategy in not only achieving Universal Health Coverage but also in Goal 3, Health, of the United Nation’s Sustainable Development Goals. Unfortunately, however, an estimated 4.5 billion people, more than half of the global population, lack access to essential health services, including primary healthcare. Research shows that despite their greater need for healthcare, people with disabilities experience greater barriers to access due to discrimination, stigma, and social disadvantages. People with disabilities make up the largest minority group in the world at 16% of the world population. Community Based Rehabilitation (CBR), a strategy developed to meet the needs of people with disabilities in low- and middle-income countries, is a multisectoral approach based on implementing services through the combined efforts and engagement of different governmental and non-governmental sectors, people with disabilities and their families, and the broader community. Health is one of the five key components of CBR. Aim: This paper aims to explore the perspectives of the various stakeholders on a CBR pilot program developed to improve access to health services, specifically primary healthcare for people with disabilities in Santiago Atitlan, Guatemala. Method: A qualitative approach was used to explore the perspectives of the CBR program’s stakeholders. A total of 27 participants were interviewed. Results: Four themes were identified: program challenges, program facilitators, program impact and sustainability of the program.  The results indicate that despite challenges faced by the program, there was a positive impact on the community and improved access to primary healthcare for people with disabilities. Conclusion: CBR has the potential to increase the inclusion of people with disabilities in mainstream health services. Implications: There remains a need for ongoing research on the impact of CBR in improving access to and use of mainstream healthcare services by people with disabilities.