Access to primary healthcare services among adults with disabilities in Brazil.

IF 2.1 4区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Revista de saude publica Pub Date : 2024-10-18 eCollection Date: 2024-01-01 DOI:10.11606/s1518-8787.2024058005842

Veronika Reichenberger, Maria Eduarda Lima de Carvalho, Tom Shakespeare, Shaffa Hameed, Tereza Maciel Lyra, Maria do Socorro Velo de Albuquerque, Loveday Penn-Kekana, Christina May Moran de Brito, Luciana Sepúlveda Köptcke, Hannah Kuper

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Abstract

Objective: To investigate perspectives of people with disabilities in Brazil regarding the access to primary healthcare.

Methods: In-depth interviews were conducted with 44 individuals with disabilities in Pernambuco, Distrito Federal, and São Paulo between March 2020 and November 2021. These interviews were transcribed, coded, and analysed thematically, using the Levesque framework to identify healthcare access barriers.

Results: Participants expressed a solid understanding of their healthcare needs and existing obstacles. However, individuals with hearing and visual impairments experience challenges because of communication barriers. In Pernambuco, the Community Health Agent was often the initial point of contact for primary care services. Public transportation lacked accessibility, from buses to driver attitudes, posing difficulties for people with disabilities. More accessible transportation and improved urban infrastructure could enhance service access. High medication costs were reported due to limited healthcare unit availability. Communication accessibility issues, inadequate audio-visual resources and equipment were also identified as barriers. Attitudinal barriers among healthcare professionals and subpar home visit services further hinder access.

Conclusion: To address these challenges and improve the well-being of individuals with disabilities in Brazil, comprehensive action is essential. This includes leadership, governance, and resource allocation reforms to meet healthcare needs. Initiatives like disability-focused training for service providers, enhanced transportation options, improved information accessibility, and increased support from community healthcare workers can collectively enhance the lives of people with disabilities.

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巴西成年残疾人获得初级医疗保健服务的情况。

目的调查巴西残疾人对获得初级医疗保健服务的看法：在 2020 年 3 月至 2021 年 11 月期间，对伯南布哥州、联邦区和圣保罗的 44 名残疾人进行了深入访谈。对这些访谈进行了誊写、编码和主题分析，并使用 Levesque 框架来识别医疗服务获取障碍：结果：受访者对自己的医疗需求和现有障碍表示了充分的了解。然而，有听力和视力障碍的人由于沟通障碍而面临挑战。在伯南布哥州，社区卫生代理通常是初级保健服务的第一联系人。公共交通缺乏无障碍设施，从公共汽车到司机的态度，都给残疾人带来了困难。更无障碍的交通和更好的城市基础设施可以提高服务的可及性。据报告，由于医疗单位有限，药物费用很高。沟通无障碍问题、视听资源和设备不足也被认为是障碍。医疗保健专业人员的态度障碍和不完善的家访服务进一步阻碍了服务的获取：要应对这些挑战并改善巴西残疾人的福祉，必须采取综合行动。这包括领导力、治理和资源分配改革，以满足医疗保健需求。为服务提供者提供以残疾问题为重点的培训、加强交通选择、改善信息无障碍以及增加社区医疗工作者的支持等举措，可以共同改善残疾人的生活。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Revista de saude publica PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

4.60

自引率

3.60%

发文量

审稿时长

4-8 weeks

期刊介绍： The Revista de Saúde Pública has the purpose of publishing original scientific contributions on topics of relevance to public health in general.