Designing Disability-Inclusive Health Systems

This feature story was originally published on the WHO Malaysia website.

"Once we ensure inclusive services, those services become available for everybody." - Mr Wong Yoon Loong, chairman of the Malaysian Confederation of the Disabled.

In Malaysia, more than 1 in 10 adults live with a disability (National Health and Morbidity Survey (NHMS) 2019). Worryingly, the data also shows that persons with disabilities are more likely to suffer from noncommunicable diseases (NCDs) and mental health conditions. The WHO Global Report on Health Equity of Persons with Disabilities highlighted that persons with disabilities are dying 20 years earlier compared to persons without disabilities, and they are experiencing poorer health outcomes. This is primarily due to health inequities caused by physical, communication, attitudinal, and financial barriers. Closing these gaps requires a whole of society approach led by the health system, including meaningful engagement of persons with disabilities.

Malaysia's Inclusive Health Initiatives

The Ministry of Health Malaysia has acknowledged the importance of healthcare for persons with disabilities for nearly three decades, with the first strategic action plan on "Health Care of Persons with Disabilities" published back in 1996. This led to the development of national programs to address impairments through early identification and multi-disciplinary interventions for children with disabilities and the strengthening of rehabilitation services. The second Plan of Action on Health Care for Persons with Disabilities (2011-2020) sought to further improve and maintain the health of persons with disabilities by strengthening the existing services.

"Once we ensure inclusive services, those services become available for everybody." - Mr Wong Yoon Loong, chairman of the Malaysian Confederation of the Disabled.

In Malaysia, more than 1 in 10 adults live with a disability (National Health and Morbidity Survey (NHMS) 2019). Worryingly, the data also shows that persons with disabilities are more likely to suffer from noncommunicable diseases (NCDs) and mental health conditions. The WHO Global Report on Health Equity of Persons with Disabilities highlighted that persons with disabilities are dying 20 years earlier compared to persons without disabilities, and they are experiencing poorer health outcomes. This is primarily due to health inequities caused by physical, communication, attitudinal, and financial barriers. Closing these gaps requires a whole of society approach led by the health system, including meaningful engagement of persons with disabilities.

Malaysia's Inclusive Health Initiatives

The Ministry of Health Malaysia has acknowledged the importance of healthcare for persons with disabilities for nearly three decades, with the first strategic action plan on "Health Care of Persons with Disabilities" published back in 1996. This led to the development of national programs to address impairments through early identification and multi-disciplinary interventions for children with disabilities and the strengthening of rehabilitation services. The second Plan of Action on Health Care for Persons with Disabilities (2011-2020) sought to further improve and maintain the health of persons with disabilities by strengthening the existing services.

^{Discussions at the workshop. Photo credit: WHO/Izarra Azuddin}

As the health system in Malaysia evolved, the focus also began to shift from providing specialized services to ensuring more equitable access to all health services. This commitment was further articulated in the Ministry of Health's Health White Paper, which outlines a vision for an equitable, accessible, and person-centered healthcare system.

Working Together to Develop a New Plan of Action

To achieve these goals, the Ministry of Health Malaysia collaborated with WHO in the development of the third National Plan of Action for Inclusive Health Care for Persons with Disabilities (2024-2030), building on the WHO's "Disability Inclusion Guide for Action." This guide aims to support Member States in achieving the highest attainable standard of health for persons with disabilities. It provides step-by-step guidance for integrating disability inclusion into health systems as countries stive to provide universal health care for all persons by 2030 under the Sustainable Development Goals.

This process included documenting the progress made through the previous Plan of Action and mapping opportunities to integrate disability inclusion across the health system, particularly in areas relating to health promotion and disease prevention, equitable health financing, and strengthening health system governance. Most crucially, representatives from the organizations of persons with disabilities were engaged throughout the process, thereby contributing key information on the barriers to health access experienced by persons with disabilities, as well as proposing practical and affordable solutions to reduce these barriers.

"We need to reduce the barriers that persons with disabilities face in accessing healthcare," noted Dr Rabindra Abeyasinghe, WHO Representative for Malaysia, Brunei Darussalam and Singapore. "This approach will benefit not only persons with disabilities but also inspire the health system to provide health for all. It is a smart investment which will help reduce health inequities and achieve universal health coverage."

^{Group photograph of all participants. Photo credit: WHO/Izarra Azuddin}

As the third National Plan of Action for Inclusive Health Care for Persons with Disabilities (2024 - 2030) is implemented, it is hoped that the health outcomes for persons with disabilities will significantly improve, leading to a healthier, more inclusive society for all.

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