|Affiliation(s):||1Institut de Réadaptation en Déficience Physique de Québec - IRDPQ, Canada|
|Conclusion (max 400 words):||
According to the United Nations, over 600 million people have a disability, 82% of which live in developing countries. They are among the poorest of the poor, not only because the level of income but also because of their bad quality of social participation, non-respect of their dignity and functional differences, inequities of access to health, education, employment, valorised social roles and exclusion or special treatment apart from the mainstream society and services. And this is worse, if that is possible, if you are a woman or a child. In order to have a global understanding of why access to health is significantly reduced for them, it is necessary to know the evolution of disability explanatory models. This issue of causality is at the heart of the problem. Disability can be perceived as an individual or a social pathology depending on whether the responsibility or the problem is focused on the person or on society. Both approaches lead to totally different strategies in how to deal with the problem of disability: a biomedical or functional approach for eliminating or curing disability, or an environmental or human rights approach for eliminating obstacles to social participation and reducing inequalities of human rights. Improving access to health and other care or support services for people with functional limitations urges to clarify what belongs to the domain of individuals and what belongs to the environmental societal factors (health policies and financing, social security systems, training, sensitisation and social attitudes, equalisation of opportunities enforcement, insurance of rights monitoring and strengths of disability rights movement) in the disability prevention or construction process. This systemic interactive process between people with body and functional differences and quality of environmental components of health and social policies and services is an operational tool for defining gaps and goals for equity of access taking into account contextual situations in a cross-disability, mainstreaming and inclusive perspective.