Accessibility Standards for Healthcare
INTRODUCTION
The Rights of Persons with Disabilities Act, 2016 (“RPwD Act”) empowers the central government to formulate standards of accessibility for persons with disabilities.1 RPwD Act also directs the governments and local authorities to take appropriate measures to provide barrier-free access in healthcare institutions.2 The Rights of Persons with Disabilities Rules, 2017 (“RPwD Rules”) specifies the applicable rules of accessibility. In furtherance of applicable rules of accessibility, the Ministry of Health and Family Welfare (“MoHFW”), through a notification dated 4 May 2023, came up with a set of guidelines called ‘Accessibility Standards for Healthcare’ (“Accessibility Standards”).3These guidelines have also been incorporated under Rule 15 of the RPwD Rules through an amendment dated 9 August 2023.4
The Accessibility Standards aim to provide easy access to medical services to persons with disabilities. These standards lay out a reference guide for creating accessible healthcare as well as training healthcare staff to achieve the intended accessibility. The guideline provides standards for barrier-free access to healthcare and medical facilities for persons with disabilities. The Accessibility Standards are applicable for all public and private hospitals, nursing homes, private clinics, public health centres, and others (including sub-centres, primary health centres, community health centres, sub-district hospitals, district hospitals, first referral units, dispensaries, medical laboratories, and diagnostic centre, etc.) It shall be noted that physical, hearing, speech and language, visual, cognitive, and mental disabilities impairment disabilities have been taken into consideration while framing the Accessibility Standards.
ACCESSIBILITY STANDARDS
The Accessibility Standards provide that the entrance area, the path from the health facility entrance to parking, parking area, the front entrance of the building, doors, route to healthcare and other related services, reception counters and service windows, writing desk and table, seating, and waiting area, access to online applications and services for communication of information includes electronic information, washrooms and changing rooms, examination room and laboratories medical equipment shall be accessible.
The guidelines provide the following Accessibility Standards for healthcare institutions in detail:
(a) Accessibility for arrival and departure zones;
(b) Accessibility for outpatients and emergency departments includes reception, waiting area, writing table or counter, payment counter, and washrooms. Accessibility Standards also states to provide a communication request form for persons with hearing disability at the reception;
(c) Accessibility to outdoor patient care zone includes patient examination room, changing room, diagnostic laboratory, laboratory toilet, dressing room, plaster room, minor procedure room, and pharmacy;
(d) Accessibility to indoor healthcare includes ward, maternity ward, ward bathroom, and emergency exit;
(e) Accessibility to medical equipment and furniture, which includes examination tables and chairs, lifts for shifting persons with locomotor disability, gynaecological examination table, radiological diagnostic equipment, mammography equipment and chairs, densitometer with adjustable height stretcher, weighing scales, commodes and shower transfer benches, complementary and alternative medicine equipment and furniture, hospital cribs and incubations units, ophthalmology and optometry chairs and tables, dental chairs, birthing chairs, infusion recliners, hospital beds, gurneys or wheeled stretcher, infusions pumps, and rehabilitation equipment. The Accessibility Standards also provide dimensions of space and specifications for the use of accessible equipment and furniture;
(f) Training programs for healthcare workers to comprehend the barriers existing in the healthcare facilities for persons with disabilities. These training programs are to be conducted via workshops, and obtaining feedback from the persons with disabilities visiting the healthcare facility. Proper training is important for better delivery of healthcare to persons with disabilities. The guidelines emphasise interacting and communicating with persons with different disabilities in different ways and methods of communication;
(g) Accessibility to information is a right of all persons with disabilities. The modes for providing such accessible information include websites, publications, social media, etc., or through direct meetings. The communication shall fulfil the needs of all groups of people in the society. For example, the language shall be easy to understand and maximum legible; and
(h) Use of information and communication technology for the benefit of persons with disabilities. It includes information on the website concerning appointment, registration, and payment facilities (like payment through debit or credit or payment app). Website and application accessibility for persons with disabilities shall be maintained in accordance with the ‘Guidelines for Indian Govt. Website (version 2.0)’5 and BIS standards IS 17802 on ‘Accessibility for ICT products and services- Requirements’.6 These guidelines intend for convenient website navigation with assistive technology for persons with disability. Applications like Co-Win and Arogya Setu were mandated to be made accessible as per these guidelines.
CONCLUSION
The Accessibility Standards is a positive step in the path of ‘Diversity, equity, and inclusion’. United Nations states that accessibility is about giving equal access to everyone.7 India has ratified the United Nations Convention on the Rights of Persons with Disability.8 India is also a signatory to the Declaration on Full Participation and Equality of People with Disability in the Asia Pacific Region9 and Biwako Millennium Framework10 for an inclusive, barrier-free place for persons with disabilities in the region of Asia and the Pacific. With the intent to align the healthcare framework with these stated international commitments, the MoHFW has introduced the Accessibility Standards. The implementation of Accessibility Standards would create an inclusive healthcare system for empowering persons with disabilities.
[1] Section 40, Rights of Persons with Disabilities Act, 2016. [2] Section 25, Rights of Persons with Disabilities Act, 2016. [3] Notification No. F. No. T.21017/20/2021-NCD.I (NPPCD)/Part, dated 4th May, 2023. [4] Right of Persons with Disabilities (Amendment) Rules, 2023 and Rule 15 (1) (g) of the Rights of Persons with Disabilities Rules, 2017. [5] https://icar.org.in/sites/default/files/inline-files/gigw-manual_Revised2018.pdf [6]https://standardsbis.bsbedge.com/BIS_SearchStandard.aspx?keyword=Accessibility%20for%20the%20ICT%20Products%20and%20Services&id=0 [7]https://www.un.org/esa/socdev/enable/disacc.htm#:~:text=Accessibility%20is%20about%20giving%20equal,that%20hinder%20persons%20with%20disabilities [8] https://pib.gov.in/Pressreleaseshare.aspx?PRID=1584572 [9] https://swachhbharatmission.gov.in/sbmcms/writereaddata/images/pdf/technical-notes-manuals/PWD-Guidelines.pdf [10] https://swachhbharatmission.gov.in/sbmcms/writereaddata/images/pdf/technical-notes-manuals/PWD-Guidelines.pdf
