Geography Reference
In-Depth Information
The deterioration in staffing, infrastructure and the availability of
drugs and equipment in basic healthcare in many low income countries,
which resulted from reduced government expenditure, led to declines in
child immunization programmes, and the re-emergence of manageable
diseases such as typhoid, TB and hepatitis, increased child- and
maternal-mortality rates, and high numbers of AIDS-related deaths
(McIntyre, 2007).
In recent years, recognition of the potentially devastating effects of
healthcare payments on poor households, combined with poverty reduc-
tion debt-relief initiatives, has led to the removal of some or all user
fees at public health centres in several countries, including South
Africa, Uganda and Zambia (McIntyre, 2007). Indeed, abolishing user
fees at the point of service delivery leads to increased uptake of, and
adherence to, antiretroviral treatment for HIV (World Health
Organization (WHO), 2008). Challenges in improving healthcare sys-
tems within this macroeconomic policy environment, however, continue
to restrict access to healthcare for the poorest people and result in sig-
nificant health inequalities, particularly for women and children living
in remote rural locations.
The dominance of constructions of health and disability as global
problems to be eradicated or prevented within development discourses
has also resulted in the neglect of disabled people's experiences. Yeo
and Moore (2003) argue that disabled people have been largely excluded
from participating in development processes and research, despite the
fact that they are disproportionately represented among the poorest
people. Although reliable statistical data on the incidence of disability/
impairment is not widely available and defining disability is problem-
atic, an estimated 10 per cent of the world population is disabled
(United Nations, 2011a). The United Nations Development Programme
estimates that 80 per cent of persons with disabilities live in developing
countries, which often have the least resources to meet their needs
(United Nations, 2011a).
The high rates of impairment and preventable illness in the global
South are largely caused by malnutrition, poverty, lack of access to
sanitation, safe drinking water, healthcare and other services, hazard-
ous work, landmines and armed conflict (Yeo and Moore, 2003;
McEwan and Butler, 2007). Being poor also increases the likelihood of
an individual experiencing ill health and becoming disabled (Yeo and
Moore, 2003). Childhood impairment is often caused by preventable
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