For most people, going to a clinic or hospital is straightforward. For many persons with disabilities across Southern Africa, it is not. Health facilities are often physically out of reach. Buildings lack ramps or accessible toilets. Staff are not trained to communicate with deaf patients or those with cognitive impairments. Health information is rarely available in accessible formats. These are not minor inconveniences — they are barriers that cost lives.

SA-PIAH works to change this. The programme focuses on making health systems in Southern Africa more accessible and more responsive to the needs of persons with disabilities. This means tackling barriers at multiple levels: physical access to facilities, the attitudes of health workers, the design of health information, and the policies that govern how services are delivered.

The programme’s approach is grounded in evidence. Research under SAFOD’s work has consistently shown that persons with disabilities are among the most underserved in health systems across the region. Health facilities in Zambia, Malawi, and Zimbabwe were found to be physically inaccessible to many persons with disabilities. Communication materials are rarely produced in Braille, sign language, or plain language. Outreach services — particularly for those in rural areas or with severe mobility difficulties — are largely absent.

SA-PIAH also addresses health issues that are often overlooked entirely. Women and girls with disabilities face particular gaps in access to sexual and reproductive health services. SAFOD and its affiliate BOFOD developed a concept note on protecting and promoting the sexual and reproductive health rights of adolescent girls and young women with disabilities in Botswana during COVID-19. The initiative, submitted to AIDS and Rights for Southern Africa (ARASA), sought to create community dialogues, build awareness, and open pathways to services for a group that is routinely excluded from health programming.

Internally, SAFOD has also worked to model the inclusion it advocates for. In 2022, SAFOD Secretariat staff received basic sign language training delivered by the Botswana Society of the Deaf — strengthening the organisation’s ability to communicate with and serve members of the deaf community more effectively.

Health is a right. SA-PIAH is built on that principle — and on the recognition that, until health systems are designed with persons with disabilities in mind, that right will remain out of reach for too many people across Southern Africa.