title: 'You must carry your wheelchair'--barriers to accessing healthcare in a South African rural area.
abstract: BACKGROUND
  There is international evidence that people with disabilities face barriers when accessing primary healthcare services and that there is inadequate information about effective interventions that work to improve the lives of people with disabilities, especially in low-income and middle-income countries. Poor rural residents generally experience barriers to accessing primary healthcare, and these problems are further exacerbated for people with disabilities.
  
  
  OBJECTIVE
  In this study, we explore the challenges faced by people with disabilities in accessing healthcare in Madwaleni, a poor rural Xhosa community in South Africa.
  
  
  METHODS
  Purposive sampling was done with 26 participants, using semi-structured interviews and content analysis to identify major themes.
  
  
  RESULTS
  This study showed a number of barriers to healthcare for people with disabilities. These included practical barriers, including geographical and staffing issues, and attitudinal barriers.
  
  
  CONCLUSIONS
  It is suggested that although there are practical barriers that need to be addressed, attitudinal barriers could potentially be addressed more easily and cost effectively.
authors.affiliation: Alan J Flisher Centre for Public Mental Health, Department of Psychology, Stellenbosch University, Stellenbosch, South Africa.
authors.forename: Richard
authors.initials: R
authors.lastname: Vergunst
authors.affiliation: Alan J Flisher Centre for Public Mental Health, Department of Psychology, Stellenbosch University, Stellenbosch, South Africa; lswartz@sun.ac.za.
authors.forename: Leslie
authors.initials: L
authors.lastname: Swartz
authors.affiliation: Centre for Rehabilitation Studies, Stellenbosch University, Stellenbosch, South Africa.
authors.forename: Gubela
authors.initials: G
authors.lastname: Mji
authors.affiliation: Centre for Rehabilitation Studies, Stellenbosch University, Stellenbosch, South Africa.|Centre for Global Health, School of Psychology, Trinity College, Dublin, Ireland.
authors.forename: Malcolm
authors.initials: M
authors.lastname: MacLachlan
authors.affiliation: School of Nursing, Midwifery & Health Systems, Health Sciences Centre, University College Dublin, Dublin, Ireland.
authors.forename: Hasheem
authors.initials: H
authors.lastname: Mannan
mesh_terms: D000293:Adolescent; D000328:Adult; D001291:Attitude of Health Personnel; D002648:Child; D002675:Child, Preschool; D006233:Persons with Disabilities; D005260:Female; D014943:Global Health; D006297:Health Services Accessibility; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D011203:Poverty; D011320:Primary Health Care; D012424:Rural Population; D013019:South Africa; D014910:Wheelchairs; D055815:Young Adult
keywords: access; barriers; disability; health; rural