Transforming Health Systems: Five Actions for Disability-Inclusive Healthcare

As the region strives toward universal health coverage, disability inclusion must be placed at the center of health reforms. It is a matter of equity and financial imperative. This piece presents five key actions to build disability-inclusive health systems.

1. Recognize the diversity of disabilities
   People with disabilities are not a homogeneous group. Physical, sensory, intellectual, and developmental disabilities each present distinct needs and barriers to accessing healthcare. 
   
   A regional universal health coverage action plan must address all challenges. For example, improving physical access to health infrastructure for people with wheelchairs or limited mobility. Equally important are supports for people with Intellectual and developmental disabilities. People with intellectual and developmental disabilities, for example, encompass a range of conditions that affect cognitive functioning, adaptive behaviors and physical health, requiring tailored approaches to care. 
    
2. Acknowledge disadvantages in existing health care systems 
   Compared to the general population, people with intellectual, and developmental disabilities face significantly higher health risks—not because of their disabilities per se, but because of being overlooked by health systems. 
   
   Research shows that they are three to four times more likely to die of circulatory diseases and twice as likely to have diabetes than the general population. These disparities stem from being invisible in data, planning, and services. Recognizing and responding to this neglect is critical to closing the health equity gap. 
    
3. Improve quality of care through inclusive training
   Healthcare providers often lack the skills and training to provide appropriate care for individuals with disabilities, leading to misdiagnoses, inadequate treatment plans, and overall poorer health outcomes for patients. 
   
   Take the case of Anna, a 32-year-old female with diabetes, a heart condition, and an intellectual disability. Due to her weak arm pulse, her blood pressure needs to be measured on her leg—a note clearly stated in her records. However, during a recent urgent care visit, a nurse skipped this check due to lack of awareness and training, compromising her care. 
   
   This example underscores how gaps in provider training can result in inadequate care, highlighting the urgency of systemic reform. Practice-based healthcare training programs—where students in nursing, social work, and medicine learn with standardized patients with disabilities—are proving effective in building competence and inclusive care practices. 
    
4. Address financial and structural barriers
   The cost of healthcare can be prohibitive for many individuals with disabilities. Financial strain can prevent them from seeking necessary medical attention and adhering to prescribed treatment plans. 
   
   Germany offers a good example. Its Action Plan for a Diverse, Inclusive, and Barrier-Free Healthcare System—a collaboration with multiple departments, the Ministry for Social Affairs, and the Ministry for Family Affairs—addresses the interconnected nature of healthcare and the need for a united approach to overcome administrative and financial complexities. Aligning healthcare with other state services addresses the hidden barriers to care. 
    
5. Promote preventive health and inclusive wellness
   As life expectancy rises, people with disabilities face increased risks of noncommunicable diseases. Investing in wellbeing programs and promoting physical activity are urgently needed. 
   
   UNESCO’s Global State of Play report highlights how inclusive physical education and sports can advance disability inclusion. In Ontario, Canada, adults with intellectual disabilities who participate in Special Olympics show a 15% lower risk of developing diabetes and a 49% lower risk of depression compared to non-participants. These programs pair individuals with and without disabilities, demonstrating that inclusive approaches benefit everyone.

Disability-inclusive universal health coverage requires more than access—it needs transformation.

The key to build health systems that leave no one behind lies in coordinated policies, multisectoral collaboration, and embedded disability inclusion at the core of universal health coverage.

Together, the five actions—recognizing diverse needs, correcting systemic neglect, training inclusive providers, removing financial barriers, and investing in wellness—form a practical roadmap toward equitable healthcare in Asia and the Pacific.

Note: Disability inclusion is part of the discussions during ADB's 1st INSPIRE Health Forum: Inclusive, Sustainable, Prosperous and Resilient (INSPIRE) Health Systems in Asia and the Pacific. The session showcased Unified Sports for Inclusive Health Access with support from ADB, Pat Doctolero, Polin Dy Ly, Special Olympics Pilipinas National Director Anthony Galicia, Bocce Head Coach Ethel Tan, and all the contributing athletes.

Asian Development Bank. 2024. Gender Equality and Disability Inclusion: Guidelines to Address the Specific Needs of Women and Girls with Disabilities.

ADB. 2022. Strengthening Disability-Inclusive Development: 2021–2025 Road Map.

Special Olympics. 2024. Possibility in Action: 2024 Special Olympics Health Report.

Special Olympics Training Resources for Healthcare Professionals.

World Health Organization. 2023. WHO Disability-Inclusive Health Services Training Package: A Companion to the Disability-Inclusive Health Services Toolkit.