The economic impacts of wheelchair use: Evidence from Central Java, Indonesia

https://doi.org/10.22146/jcoemph.47592

Agnes Bhakti Pratiwi(1*), Hermawati Setiyaningsih(2), Rizki Mahardya(3), Firdaus Hafidz(4), Diah Ayu Puspandari(5)

(1) Department of Medical Education and Bioethics, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
(2) Centre for Health Financing Policy and Health Insurance Management, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
(3) Centre for Health Financing Policy and Health Insurance Management, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
(4) Department of Health Policy and Management, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
(5) Department of Health Policy and Management, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
(*) Corresponding Author

Abstract


An estimated 10% of the global population has disabilities, and 1 out of 10 require wheelchairs. Although imperative, the provision of wheelchair services remains challenging, especially in low resource settings. Interacting barriers in availability of wheelchair services and healthcare access can negatively affect households of people with disabilities in productivity and obtaining income. The availability of wheelchair services can potentially lessen the related economic burden. However, to date there is limited evidence concerning the economic gain of the wheelchair users in Indonesia. This study aims to analyze the economic impact of using wheelchairs on households in rural Central Java Province, Indonesia. Economic gains of wheelchair users were measured using a cross-sectional survey in Central Java, Indonesia during 2017. The questionnaires consisted of three main sections, namely general information, socio-economic information before and after using adaptive wheelchair, and income and spending related information. A total of 60 adaptive wheelchair users and parent proxy completed the questionnaires. More than half (55%) of the respondents were male, became impaired in 1998, and used an adaptive wheelchair starting in 2009. Medical conditions of the respondents related to need for a wheelchair are cerebral palsy (29%), paraplegia (29%), and polio (15.5%). Three-fourths of the respondents were working in the informal sector. On average, there is a significant increase of Rp. 217,662 in monthly household income between before and after using a wheelchair. However, there was no significant difference in spending before and after using a wheelchair. Respondents feel that using a wheelchair is beneficial particularly in mobility and helping in their activities. Wheelchair use can increase the income of households with disability. Clients responded that there have been several aspects which need further support, including skills improvement, employment generation for people with disabilities, and adequate public transportation facilities.  


Keywords


disability; economic impact; household income; Indonesia; wheelchair use

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References

  1. World Health Organization. Guidelines on the provision of manual wheelchairs in less resourced settings; 2008
  2. UCPRUK-UCPWFH. Jaminan Kesehatan Khusus Penyandang Disabilitas; 2016.
  3. United Nation. Convention on the Rights of Persons with Disabilities; 2016
  4. Shields M. Use of wheelchairs and other mobility support devices. Health reports. 2004 May 1;15(3):37.
  5. Furlong M, Connor JP. The measurement of disability-related stress in wheelchair users. Archives of physical medicine and rehabilitation. 2007 Oct 1;88(10):1260-7.
  6. Visagie S, Scheffler E, Schneider M. Policy implementation in wheelchair service delivery in a rural South African setting. African Journal of Disability. 2013;2(1).
  7. McSweeney E, Gowran RJ. Wheelchair service provision education and training in low and lower middle income countries: a scoping review. Disability and Rehabilitation: Assistive Technology. 2019 Jan 2;14(1):33-45.
  8. Toro ML, Eke C, Pearlman J. The impact of the World Health Organization 8-steps in wheelchair service provision in wheelchair users in a less resourced setting: A cohort study in Indonesia. BMC Health Services Research. 2015 Dec;16(1):26.
  9. Williams E, Hurwitz E, Obaga I, Onguti B, Rivera A, Sy TR, Kirby RL, Noon J, Tanuku D, Gichangi A, Bazant E. Perspectives of basic wheelchair users on improving their access to wheelchair services in Kenya and Philippines: a qualitative study. BMC international health and human rights. 2017 Dec;17(1):22.
  10. Bray N, Noyes J, Edwards RT, Harris N. Wheelchair interventions, services and provision for disabled children: a mixed-method systematic review and conceptual framework. BMC health services research. 2014 Dec;14(1):309.
  11. Mukherjee G, Samanta A. Wheelchair charity: A useless benevolence in community-based rehabilitation. Disability and rehabilitation. 2005 May 20;27(10):591-6.
  12. Hunt PC, Boninger ML, Cooper RA, Zafonte RD, Fitzgerald SG, Schmeler MR. Demographic and socioeconomic factors associated with disparity in wheelchair customizability among people with traumatic spinal cord injury. Archives of Physical Medicine and Rehabilitation. 2004 Nov 1;85(11):1859-64.
  13. Borg J, Östergren PO. Users’ perspectives on the provision of assistive technologies in Bangladesh: awareness, providers, costs and barriers. Disability and Rehabilitation: Assistive Technology. 2015 Jul 4;10(4):301-8.
  14. Stillman MD, Bertocci G, Smalley C, Williams S, Frost KL. Healthcare utilization and associated barriers experienced by wheelchair users: A pilot study. Disability and health journal. 2017 Oct 1;10(4):502-8.
  15. Sanchez J, Byfield G, Brown TT, LaFavor K, Murphy D, Laud P. Perceived accessibility versus actual physical accessibility of healthcare facilities. Rehabilitation Nursing. 2000 Jan 2;25(1):6-9.
  16. Vergunst R, Swartz L, Mji G, MacLachlan M, Mannan H. ‘You must carry your wheelchair’–barriers to accessing healthcare in a South African rural area. Global health action. 2015 Dec 1;8(1):29003.
  17. World Health Organization. WHO global disability action plan 2014-2021: Better health for all people with disability. World Health Organization; 2015.
  18. Shore S. The long-term impact of wheelchair delivery on the lives of people with disabilities in three countries of the world. African Journal of Disability (Online). 2017;6:1-8.
  19. Grider J, Wydick B. Wheels of fortune: The economic impacts of wheelchair provision in Ethiopia. Journal of Development Effectiveness. 2016 Jan 2;8(1):44-66.
  20. Kusumastuti P, Pradanasari R, Ratnawati A. The problems of people with disability in indonesia and what is being learned from the world report on disability. American journal of physical medicine & rehabilitation. 2014 Jan 1;93(1):S63-7
  21. Visagie S, Mlambo T, Van der Veen J, Nhunzvi C, Tigere D, Scheffler E. Impact of structured wheelchair services on satisfaction and function of wheelchair users in Zimbabwe. African Journal of Disability. 2016;5(1).



DOI: https://doi.org/10.22146/jcoemph.47592

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