Analyzing Eswatini’s national disability policy reforms: access to health care implications for citizens with disabilities

Abstract

In 2012, Eswatini ratified the United Nation’s Convention on the Rights of Persons with Disabilities (CRPD), and in 2013 developed the national disability policy reform documents to implement the CRPD across different domains, including health care. The current study aimed to analyze these policy reform documents for the actors, context, and processes involved in the development and implementation of the national disability policy reform documents. It also examined the provisions made for access to health care for persons with disabilities by utilizing a novel disability policy analysis framework. In-depth interviews with key informants were conducted to substantiate the findings obtained from document reviews. Focus group discussions were then conducted with persons with disabilities, caregivers of persons with disabilities, and health care professionals as the end users of the policy documents. The goal was to establish their knowledge of these documents and to ascertain how effective they perceived these documents to be. Findings indicated that while the content of the policy documents mirror most of the CRPD’s principles, certain aspects related to geographical and financial accessibility should be reconsidered. There is evidence to suggest a gap in policy implementation, owing to the lack of disability conscientization in general and among policymakers in particular, and manifested through political, financial, and attitudinal factors. This implies a need for disability sensitivity programs, as well as clearer implementation guidelines and government’s commitment to disability rights and the process of implementing the national disability policy reform documents.