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Toward Equity in Health: A Scoping Review Protocol for Fifteen Years of Progress and Gaps in Disability-Inclusive Healthcare (2010-2025)

Makhado, L.; Makhado, T. G.

2025-09-02 public and global health
10.1101/2025.08.31.25334801 medRxiv
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BackgroundPersons with disabilities (PWDs) experience persistent disparities in accessing equitable and effective healthcare, despite the existence of global human rights frameworks. Structural, financial, attitudinal, and systemic barriers continue to impede their full inclusion in healthcare systems. Over the past fifteen years, frameworks such as the UN Convention on the Rights of Persons with Disabilities (CRPD) have sought to promote inclusive health reforms. However, implementation remains uneven, and a comprehensive synthesis of interventions is lacking. ObjectiveThis scoping review aims to map and synthesise global literature (2010- 2025) on disability-inclusive healthcare systems. It focuses on structural competency, universal design, telehealth, and community-based rehabilitation (CBR), identifying key barriers and facilitators. MethodsThe review will follow Arksey and OMalleys scoping review methodology, incorporating Joanna Briggs Institute (JBI) and PRISMA-ScR guidance. Literature will be identified through searches in PubMed, Scopus, Web of Science, CINAHL, and Google Scholar. Eligibility will be guided by the Population-Concept- Context (PCC) framework, with studies screened and charted independently by two reviewers. Thematic synthesis and evidence mapping will be used to analyse findings. No meta-analysis will be conducted due to expected heterogeneity. Expected OutcomesThe review is anticipated to categorise major systemic barriers (e.g., physical inaccessibility, provider bias, financial exclusion) and identify inclusive interventions aligned with CRPD principles. These insights will support health policy reform and training in disability-responsive care. This review addresses a key gap by systematically synthesising global evidence on disability-inclusive healthcare interventions with a specific focus on structural competency, a lens rarely applied in previous reviews. Ethics and RegistrationNo ethical approval is required. This protocol is registered with the Open Science Framework (OSF) https://doi.org/10.17605/OSF.IO/PWC92.

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