The World Health Organisation (WHO) warned in 2020 that people with disabilities, may be impacted more significantly by Covid-19 than general populations. They urged for governments to mitigate this impact by taking appropriate actions and protective measures.
As of March 2022, South Africa has experienced four major waves of Covid-19 and recorded just under 100,000 Covid-19 related deaths. Concerns have been raised that the WHO’s ominous warning had not been heeded, resulting in a bleak situation for many people with disabilities. One set of scholars argued that access to healthcare for people with disabilities in South Africa was already bad but became worse during Covid-19.
A team from the Institute of Development Studies, the Human Sciences Research Council and the National Council of and for Persons with Disabilities has undertaken research funded by UK Research and Innovation to learn more about people with disabilities’ experiences during the Covid-19 pandemic. The goal was to develop actionable recommendations for an improved disability-inclusive government response to the pandemic, including access to the Covid-19 vaccine.
Preliminary findings were published in our article ‘Perceptions of persons with disabilities on the Covid-19 vaccine roll-out in South Africa’ in the 2021 edition of the South African Health Review and are summarised below.
What we found
The official national disability prevalence rate is 7.5% in South Africa, although the actual rate is expected to be higher, making people with disabilities a very large minority group. Yet research focusing on the experiences of people with disabilities in South Africa remains disproportionately limited.
To address this, we developed and distributed an online survey in July and August 2021 that was specifically for people self-identifying as having disabilities. The survey was designed to gather quantitative and qualitative data, asking individuals about various aspects of their experiences during the pandemic. We analysed over 400 of the first responses to understand attitudes to vaccination, perceived vulnerability to the virus, desire to be vaccinated, and perceptions about the availability of Covid-19 vaccinations for them. Analysis based on the full results will be released later in 2022.
We found that the situation of many South Africans with disabilities had worsened during the pandemic. Numerous people with disabilities reported that access to specific needs, such as communication and care providers, have drastically deteriorated since the Covid-19 crisis had begun. Many people with disabilities were being put at increased risk of serious health problems from Covid-19 due to insufficient awareness of the vaccine. To overcome the current challenges faced by people with disabilities due to Covid-19 and better prepare for future crises, we argue that it is critical to ensure that the South African Disaster Management Framework is disability-inclusive.
The South Africa Covid-19 vaccination rollout began over a year ago in February 2021, focusing on frontline health workers, those aged over 60 and, more recently, those aged over 18. Despite some having increased health risks and particular needs, people with disabilities were not prioritised to receive the vaccine.
Recommendations for a disability-inclusive response
Based on our research and initial findings, we recommend that this situation needs to be addressed immediately to ensure the rights of people with disabilities to protection are realised, and that future crises can be planned for in a more disability-inclusive way.
To achieve this, we recommend that the South African Government does the following:
- Improve monitoring of needs – the diverse needs of people with disabilities in South Africa need to be monitored during the current pandemic and during future crises.
- Deliver equitable access to healthcare – this must be ensured for people with disabilities during and beyond the pandemic. Particular attention must be paid to the vaccine roll-out. Disability mainstreaming and awareness must be improved at health facilities.
- Enhance identification of, and contact with, at-risk groups – Action is needed so the most vulnerable, which may include persons with disabilities, are prioritised and accommodated for vaccination.
- Improve and strengthen partnerships – the South African Government must work with organisations of people with disabilities (OPDs) to address the need for increased information and education. These partnerships would enable a strong flow of relevant accessible information, support and services to those who need them during disasters, and to ensure that the National Disaster Management Centre urgently finalises its risk management framework for persons with disabilities.
- Develop disability inclusive recovery plans – any planning for the post-Covid-19 era should incorporate an explicitly disability-inclusive focus.
Inclusivity is needed now
We found that many South Africans with disabilities feel that their government has not been disability-inclusive in its management of the pandemic or the vaccination programme. A disability inclusive disaster framework is lacking, contributing to people with disabilities’ perceptions and experiences of inequity. Many people with disabilities wanted to be vaccinated yet were not prioritised under the Government’s plan. While impairment itself is not always linked to clinical vulnerability, many participants felt excluded from the vaccine roll-out and therefore at increased risk.
The right to access health care services for all people is enshrined in South Africa’s constitution. This is particularly important during a pandemic. People also have a right to protection and safety in situations of risk. The South African Government must step up and provide prioritised access to Covid-19 vaccinations for certain groups at particular risk, such as those with disabilities. Failure to do so will erode trust between the state and its citizens, as well as increasing the risk of detrimental health outcomes.