[Expert Solution]: Should disability-inclusive health be a…

Should disability-inclusive health be a priority in low-income countries? A case-study from Zimbabwe The National Disability Policy was launched in Zimbabwe in June 2021 and includes a range of commitments for the provision of disability-inclusive health services and rehabilitation. Fulfilment of these pledges is important, as at least 7% of the population have disabilities, and people with disabilities face greater challenges accessing healthcare services and experience worse health outcomes. However, it will require financial investment which is challenging as the needs of people with disabilities are set against a background of widespread health systems failures in Zimbabwe, exacerbated by the COVID-19 pandemic. Zimbabwe currently faces an epidemic of TB and HIV and a growing burden of non-communicable diseases (NCDs) with a lack of investment, healthcare staff or infrastructure to provide the necessary care. Urgent action is therefore needed to strengthen the health system and ‘build back better’ after both the pandemic and the regime change. The Zimbabwean government may face the dilemma, common in many low-resource settings, of whether to focus on disability or to wait until the health system has been strengthened for the majority. This paper proposed four complementary arguments why it is important to focus on people with disabilities. First, this focus respects the rights of people with disabilities, including those specified in the new National Disability Policy. Second, it will be challenging to reach the Sustainable Development Goals, including those on health and other global health targets, without including people with disabilities. Third, there is a growing rationale that disability- inclusive health systems will work better for all, and fourth, that they will create cost savings. Everyone will therefore benefit when the health systems are designed for inclusion. In conclusion, a focus on disability may help to strengthen health systems for all as well as helping to achieve human rights and global development goals. Zimbabwe is a low-income country, with 34% of its population living on under $1.90 per day (Table 1). Compared to its neighbors, Botswana and South Africa are richer, Zambia is similar in poverty level, now 61, up from a nadir of 43 in 2004 [10]. HIV prevalence in adults is approximately 13%, down from a peak of 25% in the mid-1990s [11]. However, these bright spots are overshadowed by the many signs that the health system is failing in Zimbabwe [12]. Antenatal care is low and maternal mortality is twice as high in Zimbabwe (458 per 100,000 live births) as for Zambia (213), and three times as high as Botswana (114) or South Africa (119) [9,12]. There is poor treatment coverage for conditions such as cancer, ischaemic heart disease, stroke, asthma and epilepsy and sanitation coverage remain low [9,13]. Life expectancy is higher only than Mozambique for the region [12]. Strikingly, compared to neighboring countries, Zimbabwe has few physicians and spends little on health [12]. Out of pocket health expenditure is very high – 24% – more than twice as high as in neighboring countries [12]. There is therefore a clear narrative in Zimbabwe. Lack of investment in health is reflected in low service level inputs and consequently poor health coverage and outcomes. These overall figures hide great inequalities, and the population living in rural areas is likely to experience even worse healthcare access. Investment in health and scale-up of services is needed, urgently. Rationale: The health system challenges in Zimbabwe are therefore great, amplified further by the COVID-19 pan demic. The Zimbabwean government will need to increase its health spending to address the stark health issues and build back better systems. Nevertheless, there are at least four important arguments for Zimbabwe for maintaining a focus on dis ability and thereby supporting the implementation of the 2021 Zimbabwe National Disability Policy. Paper context The one billion people with disabilities frequently have greater healthcare needs but face many barriers in acces sing services. Low income countries such as Zimbabwe face the dilemma of whether to focus on disability-inclusion now or after the health system has been strengthened for the majority. This paper proposes four arguments for why disability should be prioritized now: 1) realization of rights, 2) achievement of health goals, and 3) development of cost-effective and 4) future-proofed health systems. From the above information and the data provided(images) provide a methodology for the information for a research paper. 1. Data Evaluation: Critical appraisal of sources using quality criteria (authenticity, methodological rigor, informational value), for my research paper. 2. Data Analysis: Thematic analysis to categorize and interpret findings, for my research paper.