The linkages between disability, poverty and access to healthcare services in South Africa

M.A.Abstract: While the relationship between poverty and disability has been documented in the research literature, the complex linkages between poverty, disability and access to healthcare have received less attention, particularly in developing country contexts like South Africa. The study therefore endeavoured to explore these linkages by conducting a secondary data analysis of adult data from the South African General Household Survey (GHS) (2014). Disability was measured using the Washington Group (WG) questions. Poverty was measured by the monthly individual income as well as the household income using South African National Poverty lines. A composite measure of access to healthcare was constructed, based on location of health facility, type of transport, travelling time, type of health facility, medical aid, health status, infection with communicable or non-communicable diseases, and consultation with health practitioner or nurse about health. Key findings from the individual level of data analysis indicated that 11% of adult individuals were people with a disability with the most common type of disability being seeing difficulties. People with a disability were more likely to be female, Black Africans, older persons with a mean age of 55 years, residing in urban areas, and legally married and living together as husband and wife. People with a disability, especially in older ages, were more likely to have no schooling or only primary schooling, and 62% of people with disabilities were economically inactive compared with 37% of non-disabled persons. Demographic variables such as gender, population group, age, marital status, residential area, and education were significant predictors of individual monthly income. However, disability was not a significant predictor of individual persons’ monthly income. The income analysis identified that people with a disability were more likely to live below the upper bound poverty line, were more likely to report poor or fair health status as well as infection with both communicable and non-communicable diseases, and they were more likely to consult a health worker about their health. At the household level of analysis the results showed that 28% of households had at least one member with a disability. Households with disabled members more likely to have barriers to accessing healthcare services compared with non-disabled households. Households with disabled members were less likely to have medical aid cover, more likely to use a public healthcare facility, walk to the health facility and take a longer travelling time compared with non-disabled households. Although they were more likely to have visited the health facility during the previous 12 months, they were less satisfied compared with non-disabled..