Have we forgotten our obligation to train health workers on disability? A policy analysis in sub-Saharan Africa

People with disabilities generally have worse health outcomes than people without disabilities, leading to a 10–20-year difference in life expectancy. Research on the barriers to accessing health care frequently points to the role of health workers’ attitudes and lack of training to provide high quality health care to people with disabilities. Current training initiatives are unsystematic and limited to specific cadres or institutions. Yet, many countries that have adopted the UN Convention on the Rights of Persons with Disabilities likely have legal obligations to train health workers on disability in these laws. The purpose of this paper was to systematically explore the laws and policies in sub-Saharan Africa to understand how countries should be training their health workers. We searched WHO MiNDBANK and UN websites for disability laws and policies. We systemically extracted information across 11 domains: 1) requirements, 2) training objectives, 3) training cost, 4) training duration, 5) competencies covered, 6) educational stage, 7) training methods, 8) impairment-specific, 9) cadres, 10) benefits for attendance, and 11) monitoring and evaluation plans. 53 documents in English, French, and Portuguese from 32 countries were eligible for inclusion, while 16 countries had no disability laws or policies. Of the documents included, 24 (45%) did not have any mention of health worker training, while 17 (32%) recommended and 10 (19%) required health worker training. Most laws had no further specifications to describe training, though more robust laws and policies had information on the budget allocation, competencies, educational stage, and cadres included. Several countries in sub-Saharan Africa do have disability laws that require health worker training, and more countries should be including health worker training in their curricula to comply with their national laws.