Access to healthcare for people with disabilities in Zambia: a qualitative study

People with disabilities globally experience poorer health outcomes than people without disabilities. The United Nations Convention on the Rights of Persons with Disabilities emphasises that people with disabilities must have equal access to healthcare, yet evidence demonstrates barriers to access across contexts. Research on this topic is limited in Zambia, and this study therefore aimed to generate evidence on access to healthcare for people with disabilities in Zambia. In this qualitative study, we conducted in-depth interviews with 48 participants, including 16 adults with disabilities, 16 caregivers of a child with disabilities, 12 primary healthcare professionals, and four key informants from government and civil society. Participants were recruited from three districts in Lusaka Province (Lusaka, Chongwe and Kafue), the most populated province in Zambia. Participants were purposively sampled to maximise variation by sex, age, impairment type, district and locality (rural, urban, peri-urban). Data collection was completed in August 2022. Key themes were mapped against the Levesque Framework of healthcare access. Participants reported limited information on available services, stigma from community members and healthcare professionals, limited knowledge on disability and a lack of training for healthcare professionals, and challenges with inaccessible health facilities and transport. Some people with disabilities benefited from government schemes, such as the National Health Insurance Scheme, but implementation faced challenges and not all people with disabilities accessed these services. Government action is needed to improve disability-inclusive healthcare in Zambia, alleviating barriers to reduce health disparities. Recommended actions include training for healthcare professionals and improved facility accessibility.