ArticleNigerian medical journal : journal of the Nigeria Medical Association
Ethical Challenges Faced by Individuals with Disabilities in Accessing Healthcare: A Systematic Review of Barriers, Discrimination, and Autonomy in Decision-Making.
Article in Nigerian medical journal : journal of the Nigeria Medical Association. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Despite progressive legal frameworks such as the Rights of Persons with Disabilities (RPwD) Act, 2016, and India's ratification of the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD), persons with disabilities (PWD) continue to face ethical challenges in accessing equitable healthcare in India. The objective of the study is to systematically synthesize evidence on ethical issues related to healthcare access, specifically barriers, discrimination, and autonomy in decision-making affecting PWD in India. Methodology: A systematic search of seven electronic databases and grey literature sources was conducted for studies published between January 2005 and March 2025. Peer-reviewed quantitative, qualitative, and mixed-methods studies, along with relevant policy and advocacy reports, were eligible. Study quality was appraised using STROBE and CASP checklists for peer-reviewed literature, while grey literature was assessed based on source credibility and methodological transparency. The review protocol was registered with PROSPERO (CRD420251028645). Results: Thirty sources were included, comprising 22 peer-reviewed studies and 8 grey literature or policy documents. Most peer-reviewed studies were of moderate methodological quality. The synthesis revealed persistent physical, financial, informational, and communication barriers to healthcare access. Attitudinal and institutional discrimination by healthcare providers was commonly reported, and autonomy was frequently compromised through substituted decision-making and inaccessible consent processes, particularly among individuals with intellectual or psychosocial disabilities. Ethical challenges were more pronounced in rural, tribal, and socio-economically marginalized populations. Conclusion: Despite legal protections, significant ethical inequities in healthcare access for PWD persist in India. Strengthening implementation of existing laws, promoting disability-inclusive healthcare training, operationalizing supported decision-making, and improving disability-disaggregated health data are critical to advancing ethical, equitable, and inclusive healthcare.
Indexed as
Identifiers
42488880PMC13391100What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.