Disability inclusion and universal health coverage go hand in hand

On the occasion of International Day of Persons with Disabilities, and ahead of Universal Health Coverage (UHC) Day on 12 December, we are reminded that health is not a privilege, but a human right. Yet, for 1.3 billion persons with disabilities, this right is often out of reach.  

More than half of the world’s population still lacks access to essential health services. With persons with disabilities making up 16% of the global population, higher health-care costs worsen health inequities: from reduced access to timely care, to interrupted treatment or inability to pay for essential care. Catastrophic out-of-pocket health costs, limited health insurance packages, and lack of dedicated funding to foster accessibility in health services further accentuate the poverty cycle. When health financing systems ignore the rights and needs of persons with disabilities, they deepen inequities instead of dismantling them. 

Why UHC matters for disability inclusion  

UHC is about ensuring that everyone, everywhere, can access the health services they need without financial hardship. But “everyone” must truly mean everyone. Persons with disabilities deserve access to quality health services, just as everyone else. These are not luxuries; they are essential for health, independence and participation in society. 

Despite progress toward service coverage in many countries, financing arrangements continue to exclude persons with disabilities from essential health services - including sexual and reproductive health services, cancer prevention and screening, routine immunization, NCD prevention and management, and mental health care. Coverage gaps, narrow health benefit packages, user fees and co-payments, limited prepayment and risk pooling, and the absence of dedicated lines for accessibility and reasonable accommodation in national health budgets systematically shift costs to persons with disabilities and deter healthcare-seeking.  

Without inclusive health financing, families are forced to pay out-of-pocket for health services and associated costs. In addition to being more likely to live in poverty, persons with disabilities and their households are more likely to be driven further into poverty due to catastrophic health expenditures, creating a cycle of exclusion and poverty that undermines health and economic stability, and generates high levels of distress. 

“The cost of registration at a nearby privately-owned hospital is [too] much, so I have to travel a long distance to the state hospital because it is cheaper there, but I still have to take an interpreter with me to every antenatal visit. So, the additional cost of [a] sign language interpreter, transportation, ultrasound scans, and all other requirements for antenatal registration is too much for me.”  -Deaf woman, 27 years old, Nigeria 

"To access health care sometimes I face challenges. My family does not always have money for transport or extra tests. Sometimes this means delaying care. Clinics sometimes  give health information in long written forms or fast speech. I understand better when information is simple, clear, and explained slowly. The health centre is also far from my home; when roads are bad or buses are full, I miss appointments." -Woman with intellectual disability, 24 years old, Tanzania 

Source: Global report on health equity for persons with disabilities 

 

Disability inclusion as a fundamental driver of health equity 

Designing disability-inclusive health financing is not just the right thing to do, it is smart policy. Countries that integrate disability into health financing strategies strengthen their health systems for everyone. Inclusive policies reduce inequities, improve efficiency and build resilience. 

For example, investing in accessible primary care benefits older adults, people with chronic health conditions, and families with young children. Training health workers on disability inclusion improves quality of care across the board. And ensuring coverage for assistive technologies can unlock education and employment opportunities, fueling economic growth. 

What needs to change 

To make UHC truly universal, governments and partners must take the following actions to advance disability inclusion in their health financing strategies: 

• Make UHC, inclusive of financial protection, a national priority, considering the rights and needs of the most disadvantaged groups, such as persons with disabilities.
• Adopt and implement laws to protect people from unaffordable health costs and ensure access to facilities and services.
• Budget for an affordable package of essential health services, including health services for specific impairments and health conditions.
• Strengthen publicly funded health schemes to cover costs for the entire population.
• Eliminate health costs for those most in need.
• Make everyone’s voice count when shaping our health systems, including Organizations of Persons with Disabilities. 

These steps are not optional, but fundamental to achieving health equity for everyone, everywhere. 

A call to action 

This UHC Day, let’s voice the urgent need to advance health equity for persons with disabilities through fair and affordable health care. Governments, donors and advocates must commit to disability-inclusive health financing as a cornerstone of health for all. Because when we design for inclusion, we deliver on the promise of UHC. 

Join the movement. Share your story. Advocate for policies that put inclusion at the heart of health financing. Together, we can turn the vision of health for all into reality. 

Start here 

 

Photo credit: © WHO / Mwesuwa Ramsey