In a groundbreaking effort to advance health equity in South Africa, researchers have co-designed an innovative disability awareness toolkit aimed at transforming health and post-gender-based violence (GBV) clinical services. This pioneering work addresses a critical gap in accessibility and inclusivity for people with disabilities, who often face compounded barriers when seeking care, especially in the aftermath of traumatic experiences such as GBV. By bringing together stakeholders from diverse backgrounds, the project sets a new standard in collaborative healthcare design and offers invaluable insights for global health systems striving to be truly inclusive.
The impetus for this research stems from the complex realities confronting people with disabilities in South Africa, a country grappling with entrenched inequalities and systemic obstacles that disproportionately affect vulnerable populations. Disabled individuals frequently encounter physical, informational, and attitudinal barriers that restrict their access to quality healthcare. When these individuals become survivors of GBV, their challenges multiply, as mainstream health services are ill-equipped to accommodate their unique needs. This initiative is thus not only timely but essential in promoting dignified, equitable care.
The research team employed a co-design methodology, a participatory approach that actively involves end-users and service providers in the development process. This method ensures that the resulting toolkit is both contextually relevant and user-friendly. Central to this approach was collaboration with persons with disabilities, healthcare practitioners, and GBV service experts. By meshing experiential knowledge with clinical expertise, the toolkit embodies a holistic understanding of disability-inclusive health service provision.
One of the pivotal achievements of the study was the identification and dismantling of attitudinal barriers within healthcare environments. Stigmatization and prejudice towards disabled individuals often manifest in subtle yet pervasive ways, impacting both the quality of care and patient outcomes. The toolkit includes targeted modules that sensitize healthcare workers to these implicit biases, fostering an empathic, patient-centered ethos critical to healing and recovery. This represents a significant paradigm shift from traditional healthcare models that have largely ignored social determinants of health.
Technically, the toolkit integrates comprehensive guidelines on physical accessibility, communication accommodations, and tailored clinical protocols for post-GBV care. It includes detailed checklists for modifying clinical spaces to remove architectural obstacles, as well as instructions on employing assistive communication technologies to ensure effective information exchange. By codifying these technical standards, the toolkit provides practical, actionable solutions that health facilities can implement to become fully inclusive environments.
The study also underscores the importance of training and capacity building among healthcare staff. Disability awareness is not innate and requires deliberate educational efforts to embed inclusive practices into daily clinical routines. The toolkit offers modular training curricula that can be integrated into existing professional development programs. This component ensures sustainability and scalability, enabling broader systemic change beyond the initial pilot sites.
In addition to structural and educational components, the toolkit addresses policy-level considerations. It encourages alignment with national health frameworks and human rights instruments, reinforcing the legal and ethical imperatives of disability-inclusive care. This strategic alignment enhances the toolkit’s legitimacy and advocates for institutional accountability, thereby fostering an enabling environment for long-term improvements.
The researchers provided evidence of the toolkit’s efficacy through pilot implementations in select South African clinics, where it demonstrably improved service accessibility and client satisfaction among disabled survivors of GBV. Qualitative feedback highlighted increased confidence among healthcare workers in managing complex cases with sensitivity and competence. Moreover, patients reported feeling more respected and understood, a crucial factor in promoting sustained engagement with health services.
Scientifically, this work contributes to the nascent but rapidly evolving field of disability-inclusive healthcare design. It exemplifies how interdisciplinary research can address multifaceted challenges through innovative, user-centered solutions. By rigorously documenting the co-design process and outcomes, the study offers a replicable model adaptable to other low-resource settings facing similar systemic barriers.
The toolkit’s development also involved integrating principles from social justice, human rights, and health equity theories, transcending purely technical interventions to encompass a broader socio-political vision. This comprehensive lens underscores that disability inclusion is not merely a clinical concern but a fundamental human rights issue demanding cross-sectoral collaboration and policy coherence.
Importantly, the initiative harnessed digital technologies to enhance dissemination and usability. The toolkit is designed as an open-access digital resource, facilitating widespread adoption and iterative refinement based on user feedback. This digital orientation aligns with global trends in health innovation and harnesses technology’s potential to democratize knowledge and tools.
The timing of this work is critical, occurring amid heightened global attention to GBV and disability rights catalyzed by the COVID-19 pandemic’s revelations of systemic inequalities. The toolkit model resonates beyond South Africa, offering transferable insights for international stakeholders committed to inclusive health systems and survivor-centered GBV responses worldwide.
Future directions outlined by the research team include rigorous impact evaluations, integration with mental health services, and expansion to encompass other marginalized groups with intersecting vulnerabilities. These ambitions reflect the dynamic nature of health equity work and the necessity for ongoing innovation informed by evolving social realities.
In conclusion, this co-designed disability awareness toolkit marks a significant advance in inclusive health service provision, with profound implications for survivors of gender-based violence. By centering the voices and expertise of disabled individuals and practitioners, the research embodies a transformative approach to combatting systemic exclusion. Its successful implementation offers a beacon of hope for equitable healthcare access, dignified treatment, and ultimately, a more just society.
The implications of this study extend beyond immediate healthcare contexts, contributing to a global discourse on inclusive design, participatory policymaking, and intersectional approaches to health equity. As health systems worldwide grapple with inequities laid bare by pandemics, conflicts, and social upheaval, models like this provide a roadmap for meaningful, sustainable change that honors the dignity and rights of all individuals.
Through meticulous collaboration, innovative design, and rigorous evaluation, the team has crafted a powerful tool that transcends traditional healthcare barriers. The disability awareness toolkit stands as a testament to the possibility of inclusive, accessible, and compassionate health services that respond effectively to the nuanced needs of all survivors, setting new benchmarks for health equity worldwide.
Subject of Research: Development of a disability awareness toolkit for disability-inclusive and accessible health and post-gender-based violence clinical services in South Africa.
Article Title: Co-designing the disability awareness toolkit for disability-inclusive and accessible health and post-GBV clinical services in South Africa.
Article References:
Hanass-Hancock, J., Ndlovu, T., Willan, S. et al. Co-designing the disability awareness toolkit for disability-inclusive and accessible health and post-GBV clinical services in South Africa. Int J Equity Health 24, 292 (2025). https://doi.org/10.1186/s12939-025-02664-3
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