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      Cultural barriers in access to healthcare services for people with disability in Iran: A qualitative study

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          Abstract

          Background: People with disability experience various problems to access to healthcare services. This study aimed to identify cultural barriers in access to healthcare services for people with disability in Iran.

          Methods: We conducted a qualitative study using content analysis to identify the cultural barriers. We used semi-structured interviews to collect data. Participants were selected through purposeful sampling with maximum variation. 50 individual interviews were conducted with three groups of people with disability, healthcare services providers and policy makers, September to May 2015, at different locations in Tehran, Iran.

          Results: We identified a number of different cultural barriers in access to health services for people with disability in Iran. These related to health service providers, namely reluctance to provide health services and disrespect; related to People with disability, namely denial of disability, disproportionate expectation, shame and insufficient sociocultural supports; and related to policy makers, namely lack of concern, little attention to the culture of disability and discrimination. We categorized misconception as a barrier that was observed at all levels of the society.

          Conclusion: Disability is a reality that some human being may experience and live with it. The negative attitude towards people with disability has a close relationship with the cultural norms of a society. The culture of disability in different dimensions should be a priority for all policy makers. Removing cultural barriers in access to healthcare for people with a disability needs collective efforts and collaborations among all stakeholders.

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          Most cited references37

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          What does 'access to health care' mean?

          Facilitating access is concerned with helping people to command appropriate health care resources in order to preserve or improve their health. Access is a complex concept and at least four aspects require evaluation. If services are available and there is an adequate supply of services, then the opportunity to obtain health care exists, and a population may 'have access' to services. The extent to which a population 'gains access' also depends on financial, organisational and social or cultural barriers that limit the utilisation of services. Thus access measured in terms of utilisation is dependent on the affordability, physical accessibility and acceptability of services and not merely adequacy of supply. Services available must be relevant and effective if the population is to 'gain access to satisfactory health outcomes'. The availability of services, and barriers to access, have to be considered in the context of the differing perspectives, health needs and material and cultural settings of diverse groups in society. Equity of access may be measured in terms of the availability, utilisation or outcomes of services. Both horizontal and vertical dimensions of equity require consideration. Copyright The Royal Society of Medicine Press Ltd 2002.
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            Culture and depression.

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              Race, ethnicity, culture, and disparities in health care.

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                Author and article information

                Journal
                Med J Islam Repub Iran
                Med J Islam Repub Iran
                MJIRI
                Med J Islam Repub Iran
                Medical Journal of the Islamic Republic of Iran
                Iran University of Medical Sciences
                1016-1430
                2251-6840
                2017
                03 September 2017
                : 31
                : 51
                Affiliations
                1 Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
                2 Department of Global Health and Public Policy, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
                3 Health Equity Research Centre (HERC), Tehran University of Medical Sciences, Tehran, Iran
                4 Department of Epidemiology and Biostatistics, School of Public Health, and Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran.
                5 Department of Rehabilitation Management, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
                Author notes
                Corresponding author: Dr Amirhossein Takian takian@ 123456tums.ac.ir
                Article
                10.14196/mjiri.31.51
                5804431
                29445680
                e2896f44-ec70-49ce-8fe4-674795741502
                © 2017 Iran University of Medical Sciences

                This is an open-access article distributed under the terms of the Creative Commons Attribution NonCommercial 3.0 License (CC BY-NC 3.0), which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.

                History
                : 07 June 2016
                Page count
                Tables: 3, References: 49, Pages: 7
                Categories
                Original Article

                disability,access,healthcare,culture
                disability, access, healthcare, culture

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