Despite the rise in self-reported disability in Bhutan, accessibility in health facilities for persons with disabilities, is low, particularly in primary healthcare facilities. This is according to the National Health Survey and the Service Delivery Indicators Survey published by the health ministry this year. Considering the need for better accessibility, the health ministry has allocated Nu 3 M to conduct a comprehensive assessment of disability-friendly infrastructure and features in health facilities in the 13th Five-Year Plan.
From a little over two per cent in the Population and Housing Census of Bhutan 2017, the disability rate in Bhutan has increased to almost seven per cent as per the National Health Survey 2023.
The 2023 survey reveals the prevalence of visual impairment cases is almost two per cent while hearing and mobility impairment are both at two per cent.
Meanwhile, communication disability is almost one per cent, while self-care disability stands at over two per cent, and over one per cent of the population is living with cognitive disability.
According to the survey, the prevalence of almost all disability is higher in rural areas with the rate going up to over 8 per cent compared to a little over four per cent in urban areas.
Meanwhile, about three per cent of the population is found bypassing their nearest health facilities in rural areas to avail themselves of services in other places where health facilities are disability-friendly.
Moreover, the Service Delivery Indicators or SDI survey, which collected data from 280 health facilities, shows only 13 per cent have handicap-accessible toilets and only over two per cent have assistive technology for the visually impaired.
The survey also found out that only over 14 per cent of the health facilities have ramps for wheelchair users.
Organisations that cater to persons with disabilities such as Draktsho say their beneficiaries often face challenges due to the lack of accessible services in the hospitals.
“There are many types of persons with disabilities and also the severity. Some are mild, some are moderate, some are severe, some require wheelchairs, and some require other assistive devices. I think the toilets in the hospitals are not so disability-friendly, and even the ramps I have seen are steep,” said Deki Zam, executive director at Draktsho.
Moreover, parents whose children have invisible disabilities such as autism among many other cognitive disabilities say they often settle in urban areas because their nearest health facilities do not cater to their children with such disability.
They also said they have to often wait in queues while availing themselves of health services despite their children’s inability to wait.
“When we take our children to hospital, our children look normal. That’s why we have faced issues such as waiting in queues. Receptionists do not understand even if we go to them directly to inform them about our children’s condition. They say our children are normal and send us back to the queue,” said Namgay Zangmo, a parent.
“So I think it is important for the front liners or the service providers at the hospitals to have capacity building so they can provide equal opportunity and services to person with disabilities,” added Deki Zam, executive director at Draktsho.
They added that this issue could also be solved if the government provided them with disability cards for their children.
Considering these challenges, the Disability Prevention and Rehabilitation Programme under the Department of Public Health says the ministry will conduct on-site inspections of existing health facilities to evaluate current infrastructure and features such as ramps, entrances, pathways, restrooms, patient rooms, and common areas for accessibility.
The ministry says the assessment will be conducted in collaboration with all relevant stakeholders such as CSOs, local government, healthcare professionals and government agencies.
Furthermore, the ministry says they are currently discussing the issuance of Disability Certificates for persons with disabilities.
Section 8.1 of the National Policy for Persons with Disabilities, 2019 requires the health ministry to introduce measures to assist persons with disabilities in accessing health facilities and services.
Singye Dema
Edited by Kipchu
