Salud sexual y reproductiva en tiempos del COVID-19: accesibilidad de mujeres sordas y con discapacidad auditiva  <span class="so-article-trans-title" dir="auto"> Translated title: Access of chilean deaf women to healthcare information and reproductive care </span>

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Translated abstract

Background: The COVID-19 pandemic threatened the accessibility and response of healthcare systems worldwide. People with disabilities face specific access challenges to healthcare services and to healthcare information in accessible formats. Aim: To explore how deaf women acceded to information and sexual and reproductive health care during the first wave of COVID-19. Material and Methods: Sixty-one women with a median age of 32 years diagnosed with deafness and hearing loss were surveyed using an online questionnaire about access to healthcare information and midwifery care during the COVID-19 pandemic. Results: Forty-nine percent of respondents lived in the Metropolitan Region. Sixty-eight percent of respondents mentioned that information about COVID-19 was not accessible for them. The main source of information that they used to learn about the pandemic were videos made by deaf people available on the internet. Seventy-five percent of women reported that they had not received accessible information about sexual and reproductive health, and 70.0% of women requiring midwife care could not book an appointment. Conclusions: The pandemic generated a crisis in the Chilean healthcare system that demands a new strategy to ensure people's healthcare access. People with disabilities such as those herein studied are marginalized when these new policies are being discussed and implemented. Decision-makers and sexual and reproductive health services must improve their strategies to allow women with disabilities, particularly deaf women gain access.

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The COVID-19 response must be disability inclusive

Richard Armitage, Laura Nellums (2020)

There are more than 1 billion people living with disabilities (PLWD) worldwide. The coronavirus disease 2019 (COVID-19) pandemic is likely to disproportionately affect these individuals, putting them at risk of increased morbidity and mortality, underscoring the urgent need to improve provision of health care for this group and maintain the global health commitment to achieving Universal Health Coverage (UHC). 1 PLWD, including physical, mental, intellectual, or sensory disabilities, are less likely to access health services, and more likely to experience greater health needs, worse outcomes, and discriminatory laws and stigma. 2 COVID-19 threatens to exacerbate these disparities, particularly in low-income and middle-income countries, where 80% of PLWD reside, and capacity to respond to COVID-19 is limited.3, 4 Preparedness and response planning must be inclusive of and accessible to PLWD, recognising and addressing three key barriers. First, PLWD might have inequities in access to public health messaging. All communication should be disseminated in plain language and across accessible formats, through mass and digital media channels. Additionally, strategies for vital in-person communication must be safe and accessible, such as sign language interpreters and wearing of transparent masks by health-care providers to allow lip reading. Second, measures such as physical distancing or self-isolation might disrupt service provision for PLWD, who often rely on assistance for delivery of food, medication, and personal care. Mitigation strategies should not lead to the segregation or institutionalisation of these individuals. Instead, protective measures should be prioritised for these communities, so care workers and family members can continue to safely support PLWD, who should also be enabled to meet their daily living, health care, and transport needs, and maintain their employment and educational commitments. Third, PLWD might be at increased risk of severe acute respiratory syndrome coronavirus 2 infection or severe disease because of existing comorbidities, and might face additional barriers to health care during the pandemic. 2 Health-care staff should be provided with rapid awareness training on the rights and diverse needs of this group to maintain their dignity, safeguard against discrimination, and prevent inequities in care provision. COVID-19 mitigation strategies must be inclusive of PLWD to ensure they maintain respect for “dignity, human rights and fundamental freedoms,” 5 and avoid widening existing disparities. This necessitates accelerating efforts to include these groups in preparedness and response planning, and requires diligence, creativity, and innovative thinking, to preserve our commitment to UHC, and ensure people living with disabilities are not forgotten.

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Health Care Access Among Deaf People.

Johannes Fellinger, Alexa Kuenburg, Paul Fellinger (2016)

Access to health care without barriers is a clearly defined right of people with disabilities as stated by the UN Convention on the Rights of People with Disabilities. The present study reviews literature from 2000 to 2015 on access to health care for deaf people and reveals significant challenges in communication with health providers and gaps in global health knowledge for deaf people including those with even higher risk of marginalization. Examples of approaches to improve access to health care, such as providing powerful and visually accessible communication through the use of sign language, the implementation of important communication technologies, and cultural awareness trainings for health professionals are discussed. Programs that raise health knowledge in Deaf communities and models of primary health care centers for deaf people are also presented. Published documents can empower deaf people to realize their right to enjoy the highest attainable standard of health.