Empowerment health focuses on providing people with disabilities with the skills needed to overcome barriers and the tools to resolve challenges regarding their health
Written by Christel van Eeden
As a paraplegic for almost 20 years, I thought I have seen it all. Until I became pregnant three years ago and had to experience life as a pregnant woman, but from a wheelchair. What was almost shocking to me, was how ill-equipped the (private) healthcare system was to handle a paralysed person’s pregnancy. I was not able to visit the gynaecologist alone since we needed a few sets of hands to lift me up to and down from the very narrow examination bed.
The inaccessibility of the hospital rooms in the maternity ward – from too narrow bathroom doors to no shower chairs – had me resorting to doing bed-washes and dry-shampooing my hair all three times I was admitted with bladder infections caused by the permanent wearing of the foley catheter.
A year after my baby was born, I applied for a master’s degree. My focus is on inclusivity of persons in wheelchairs in South Africa, starting with the healthcare system, looking at health promotion.
In earlier years, “disability” was not associated with terms like health promotion or wellness. The person with the disability was already viewed as “impaired” and “not well” and therefore no further effort was undertaken to better the health of persons with disabilities. When it became evident that a person with a physical disability could live as long as a person without a disability, more focus was placed internationally on how persons with disabilities could improve their health by preventing diseases and secondary health conditions.
The term “Empowerment health” was used to explain the importance of health promotion programmes for persons with disabilities. Empowerment health focuses on training the person with the disability to develop skills to overcome perceived barriers and give them the tools to resolve challenges regarding their health, by means of exercise and diets.
Persons with disabilities thus gained the authority to increase control over the improvement of their health. Healthier lifestyles for persons with disabilities could, for example, be obtained by making better choices regarding nutrition, undertaking physical exercises three to four times a week, and taking vaccines and vitamin supplements.
A proposed model for “Empowerment health” suggests three key aspects to include for inclusive health promotion programmes for persons with physical disabilities:
- to reduce or prevent secondary health conditions,
- to improve functional health to enable the person with the disability to participate independently in community activities, and
- to advocate for accessibility to social and built environments.
There is also a reciprocal aspect to consider in making the environment accessible and ultimately empowering the person with a disability to lead a healthier life. An example is when a person with a disability wants to invest in a health promotion programme, but cannot access an accessible adapted fitness facility to exercise.
Thus, if the environment is not accessible, the person with a disability will likely not achieve an active, healthy lifestyle. Again, accessibility leads to inclusivity of persons with physical disabilities, which ultimately leads to the person in the wheelchair being able to lead an independent life.
In South Africa, the South African National Health Promotion Policy and Strategy (2015 – 2019) lists persons with physical disabilities as one of the target populations requiring health promotion interventions.
Although persons with physical disabilities are listed as a target population, it still seems that not enough has been done to better the health of these persons. It is not supposed to be an effort for a person with a physical disability to wait all day in long lines to see a doctor at a public hospital, or to access a clinic for basic medical services. Yet, it still is.
With my research, I am planning on proposing guidelines toward the inclusivity of high-functioning adults with paraplegia in South African health promotion programmes and I hope that I could at least empower one person with a physical disability to take charge of their health to improve it.
Persons with paraplegia who are interested in participating in my study can send an e-mail to 33023654@nwu.ac.za.
About the author
Christel has been a paraplegic for 20 years and is a wife and a mom. She is currently busy with a Master’s degree in Transdisciplinary Health Promotion and is passionately seeking for answers to everyday questions on accessibility, inclusivity and independence. She is also a wheelchair- accessibility consultant and registered trauma counsellor.
