From policy to practice: barriers and enablers to the inclusion of healthcare workers with disabilities in public healthcare facilities in KwaZulu-Natal, South Africa.

Abstract

This study explored the barriers and enablers to achieving the standards outlined in South African disability inclusion frameworks, from the perspectives of healthcare workers with and without disabilities in the public healthcare sector in KwaZulu-Natal. Guided by a transformative paradigm, an exploratory qualitative descriptive design was employed. Individual semi-structured interviews were conducted with healthcare workers across multiple public healthcare facilities in KwaZulu-Natal. Interviews were transcribed verbatim and analysed thematically. Six major themes emerged: (1) spatial exclusion and architectural ableism; (2) stigma and professional devaluation; (3) exclusionary recruitment practices; (4) institutional ableism and budgetary exclusion mechanisms; (5) institutional neglect and governance failure; and (6) promotion of universal design and access. Healthcare workers with disabilities continue to face entrenched structural, institutional, and attitudinal barriers that undermine their right to work on an equal basis with others. The promotion of universal design and reasonable accommodation emerged as key enablers for advancing disability inclusion in the public healthcare sector.