Improving Accessibility to Medical Services for Persons with Disabilities in Thailand

Purpose: This action research aimed at developing an action plan to improve the accessibility to home health care and assistive devices for persons with disabilities in a rural community, and to evaluate changes in the numbers of such persons who received appropriate home health care and assistive devices after a three-month implementation of the action plan. Method: The study was conducted at a sub-district of Maha Sarakham Province, Thailand. The main beneficiaries were 99 persons with disabilities (mean age55.4±18.7 years). Group meetings were organised for persons with disabilities, caregivers, and various community members. An action plan for improving the accessibility of persons with disabilities to home health care and assistive devices was collaboratively formulated and implemented for three months. Results: The main strategy for improving accessibility was to increase the competency of village health volunteers in providing home health care and assistive devices to persons with disabilities. After the three-month action plan implementation, the number of persons with disabilities who received appropriate home health care, i.e. at least once a month, significantly increased from 33.3% to 72.2% (Chi-square test, P<0.01, 95% CI 18.5 to 59.3). The number of persons who received assistive devices suited to their disabilities also significantly increased from 33.3% to 58.3% (Chi-square test, P=0.03, 95% CI3.5 to 46.5). Conclusions: Under the supervision of physical therapists and/or other allied health professionals, the village health volunteer is likely to be a key person for improving the accessibility to home health care and assistive devices for persons with disabilities in a rural community. Limitations: The study was limited to only one sub-district. No comparable areas were studied. Further, since the study recruited persons with disabilities from a rural community, applicability of the findings to persons with disabilities in an urban community should be considered judiciously.