Original Research

‘These are not luxuries, it is essential for access to life’: Disability related out-of-pocket costs as a driver of economic vulnerability in South Africa

Jill Hanass-Hancock, Siphumelele Nene, Nicola Deghaye, Simmi Pillay
African Journal of Disability | Vol 6 | a280 | DOI: https://doi.org/10.4102/ajod.v6i0.280 | © 2017 Jill Hanass-Hancock, Siphumelele Nene, Nicola Deghaye, Simmi Pillay | This work is licensed under CC Attribution 4.0
Submitted: 28 April 2016 | Published: 31 May 2017

About the author(s)

Jill Hanass-Hancock, Medical Research Council South Africa, South Africa; Health Economics HIV and AIDS Research Division, University of Kwazulu-Natal, South Africa
Siphumelele Nene, Health Economics HIV and AIDS Research Division, University of Kwazulu-Natal, South Africa
Nicola Deghaye, Health Economics HIV and AIDS Research Division, University of Kwazulu-Natal, South Africa
Simmi Pillay, National Department of Social Development, University of Cape Town, South Africa


Share this article

Bookmark and Share

Abstract

Background: With the dawn of the new sustainable development goals, we face not only a world that has seen great successes in alleviating poverty but also a world that has left some groups, such as persons with disabilities, behind. Middle-income countries (MICs) are home to a growing number of persons with disabilities. As these countries strive to achieve the new goals, we have ample opportunity to include persons with disabilities in the emerging poverty alleviation strategies. However, a lack of data and research on the linkages between economic vulnerability and disability in MICs hampers our understanding of the factors increasing economic vulnerability in people with disabilities.
Methods: This article aims to present data related to elements of this vulnerability in one MIC, South Africa. Focusing on out-of-pocket costs, it uses focus group discussions with 73 persons with disabilities and conventional content analysis to describe these costs.
Results: A complex and nuanced picture of disability-driven costs evolved on three different areas: care and support for survival and safety, accessibility of services and participation in community. Costs varied depending on care and support needs, accessibility (physical and financial), availability, and knowledge of services and assistive devices.
Conclusions: The development of poverty alleviation and social protection mechanisms in MICs like South Africa needs to better consider diverse disability-related care and support needs not only to improve access to services such as education and health (National Health Insurance schemes, accessible clinics) but also to increase the effect of disability-specific benefits and employment equity policies.

Keywords

disability; poverty; economic vulnerability; South Africa

Metrics

Total abstract views: 1334
Total article views: 2943

 

Crossref Citations

1. People with disabilities and income-related social protection measures in South Africa: Where is the gap?
Jill Hanass-Hancock, Tamlyn C. McKenzie
African Journal of Disability  vol: 6  year: 2017  
doi: 10.4102/ajod.v6i0.300