In the wake of the COVID-19 pandemic, global public health strategies rapidly evolved to mitigate the virus’s spread. While many measures were effective in the general population, a critical question has emerged regarding their inclusivity for people with disabilities, particularly in low- and middle-income countries (LMICs). Recent qualitative research conducted across eight such countries sheds light on the critical gaps and successes in pandemic response strategies as they pertain to this vulnerable segment of society. This investigation delves into how these strategies were adapted, or in many cases not adapted, to address the diverse needs of people with disabilities, revealing essential insights into public health equity during a global crisis.
The study, led by researchers Hunt, Marks, Hameed, and their colleagues, utilized qualitative methods including interviews and focus groups to capture lived experiences of individuals with disabilities amidst the pandemic’s challenges. Across diverse cultural, economic, and infrastructural contexts, barriers to accessing critical information, healthcare services, and social support systems emerged as recurring themes. Many participants reported feeling excluded from mainstream communication channels that disseminated health directives, highlighting profound shortcomings in the inclusivity of urgent public health messaging.
One significant concern arises from the design and implementation of preventive strategies such as social distancing, mask mandates, and hygiene protocols. For many individuals with physical, sensory, or cognitive disabilities, adhering to these recommendations was intricately complicated by additional obstacles. For example, visually impaired participants described difficulties in navigating public spaces with safety measures in place, while individuals reliant on personal assistants faced challenges in maintaining physical distance without losing crucial support. Such findings underscore the inadequacy of “one size fits all” approaches to pandemic prevention.
From a technical standpoint, the research emphasizes the need to incorporate universal design principles within epidemic preparedness frameworks. This involves creating communication materials accessible in multiple formats—braille, sign language, audio descriptions—and ensuring healthcare and social services are physically and cognitively accessible. The study documents cases where exclusionary practices not only heightened risks for people with disabilities but also exacerbated social isolation and mental health issues, compounding the pandemic’s toll.
The interplay between socioeconomic factors and disability status featured prominently in the analysis. In resource-constrained settings, healthcare infrastructure often lacks the capacity to prioritize vulnerable groups. The survey revealed wide disparities in access to COVID-19 testing, treatment, and vaccination programs for people with disabilities. In many instances, lack of transportation, limited caregiver availability, and systemic discrimination impeded timely and effective care, amplifying health inequities during the crisis.
Moreover, the research elaborates on the policy-level neglect of disability-inclusive approaches within national responses. Although international guidelines by bodies such as the World Health Organization advocate for accessible public health strategies, implementation inconsistencies were widespread. Policy documents frequently overlooked the requirements of people with disabilities, resulting in absence of targeted interventions, funding allocations, and data disaggregation necessary to monitor equity outcomes.
An important contribution of this work is its comparative cross-country analysis that elucidates contextual enablers and barriers. Countries that integrated disability rights organizations and stakeholders into pandemic planning demonstrated higher levels of inclusivity. These participatory approaches facilitated tailored solutions such as specialized helplines, home-based service delivery, and adapted informational campaigns, proving that meaningful engagement is vital for responsive health governance.
Technically, recommendations put forth include the urgent adoption of intersectional frameworks in epidemic response mechanisms. Intersecting axes of vulnerability, such as disability combined with gender, age, or socioeconomic deprivation, must inform tailored interventions. This requires systematic collection of disaggregated data and embedding inclusive metrics within public health monitoring systems. Failure to do so risks perpetuating invisibility and marginalization during health emergencies.
The psychosocial dimensions investigated reveal that many people with disabilities experienced heightened anxiety and uncertainty due to inadequate communication and social support during lockdowns. Lack of accessible mental health services compounded these issues. The study highlights successful instances where community-based organizations bridged gaps by delivering psychosocial aid and practical assistance, offering vital lessons for future crisis preparedness.
In light of the digital divide prevalent in LMICs, reliance on online platforms for health promotion and vaccination registration inadvertently excluded many. The study details how technological accessibility barriers affected remote consultations and information dissemination, calling for multimodal approaches that prioritize offline and community-based modalities in future public health strategies.
A particularly technical challenge examined is in adapting infection prevention protocols in institutional settings such as schools and rehabilitation centers. These environments cater to high concentrations of vulnerable individuals but often lacked tailored guidance early in the pandemic. Training of staff on disability-sensitive practices and ensuring physical accessibility of hygiene infrastructure were identified as critical gaps requiring urgent redress.
The research also scrutinizes how international aid and funding mechanisms addressed disability inclusion within pandemic responses. Findings suggest inconsistency and often superficial integration of disability considerations in funding criteria. The study argues for explicit disability-inclusive conditionalities to ensure equitable resource allocation and program design.
From an ethical perspective, the study reinforces that health equity mandates intentional inclusion of marginalized populations in epidemic planning. The exclusion of people with disabilities contravenes principles of justice and human rights enshrined in global frameworks like the UN Convention on the Rights of Persons with Disabilities. Embedding these values concretely into practice requires advocacy, education, and systemic change.
Importantly, this comprehensive qualitative inquiry contributes empirical evidence to a field historically dominated by epidemiological modelling and biomedical data, offering a nuanced understanding of social determinants of health during pandemics. By centering voices of people with disabilities, it challenges dominant narratives and calls for transformative approaches that prioritize inclusivity, accessibility, and dignity.
In conclusion, the COVID-19 pandemic exposed and exacerbated longstanding inequities faced by people with disabilities in LMICs. Inclusive public health strategies are not merely ethical imperatives but necessary for effective disease control and societal resilience. This research charting successes and failures provides a roadmap for building more inclusive health systems capable of protecting all citizens in future global health emergencies.
Subject of Research: How inclusive were strategies to prevent the spread of COVID-19 for people with disabilities in low- and middle-income countries.
Article Title: How inclusive were strategies to prevent the spread of COVID-19 for people with disabilities? Evidence from qualitative research in eight low- and middle-income countries.
Article References:
Hunt, X., Marks, S., Hameed, S. et al. How inclusive were strategies to prevent the spread of COVID-19 for people with disabilities? Evidence from qualitative research in eight low- and middle-income countries. Int J Equity Health 24, 121 (2025). https://doi.org/10.1186/s12939-025-02482-7
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