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Classification schemes make things happen. The Australian Disability Discrimination Act (DDA), which derives its classification system from the World Health Organization's International Classification of Functioning, Disability and Health (ICF), legislates for adjustments to support the inclusion of people with disability. This study explores how students with disability enrolled in a university experience the systems intended to facilitate their studying “on the same basis” as students without disability.

Through an online questionnaire and interviews comprising open and closed questions made available to students registered with the disability services unit of a university and follow-up interviews with a small number of students, students’ views of their own disability and effects on their participation in learning were gathered, alongside reports of their experiences of seeking support in their learning. Interview data and responses to open-ended questions were analysed using a priori and emergent coding.

The findings demonstrate that students are aware of the workings of the classification scheme and that most accept them. However, some students put themselves outside of the scheme, often as a way to exercise autonomy or to assert their “ability”, while others are excluded from it by the decisions of academic staff. Thus, the principles of fairness and equity enshrined in legislation and policy are weakened.

Through the voices of students with disability, it is apparent that, even though a student's classification according to the DDA and associated university policy remains constant, the outcomes of the workings of the scheme may reveal inconsistencies, emerging from the complexity of bureaucracy, processes and the exercises of power.

The purpose of this paper is to present the results of a critical analysis of the disability models developed to date and of how they function in practice. Furthermore, it aims to answer the following question: which model of disability (MD) will provide the most suitable foundation for any course of action undertaken in the process of planning accessible tourism development in the future?

In the first stage of the study a critical analysis of the MDs described in the literature as well as in selected reports and expert opinions relating to people with disability (PwD) was performer. These findings then became the basis for the second stage of the study which focuses on identifying attitudes within society towards the types of tourism on offer connected to the analysed MDs. The applied research methods include an analysis of a survey (2013, 2014) carried out face-to-face and on the SurveyMonkey web site. The study group consisted of 619 people (from Poland, Russia, Germany, Portugal, Slovakia, Canada, Tunisia and Great Britain).

The great diversity of disabilities makes finding a universal solution in the creation of accessible tourism supply a complex task. This supports the need for a flexible “mix of various models” aimed at finding optimal solutions and the personalisation of tourism. In this context the greatest potential in the development of accessible tourism are models which are a synthesis of many determiners of disability such as the biopsychosocial or the geographical model of disability. The dynamics of accessible tourism development is likely to be increasingly influenced by the economic model, reflecting current trends for the personalisation of tourism supply.

The survey was carried out mainly within the European Community, the exception being respondents from Irkutsk in eastern (Asian) Russia. In order to gain a global view of the development of accessible tourism, research should be performed in countries representing all continents or tourist regions. Additionally, reflecting the definition of accessible tourism its beneficiaries – PwD – should participate in decision-making processes. Tourism service providers who are directly engaged in tourism supply also have a role to play. Their opinions and attitudes towards the development of accessible tourism determine its very nature in reality.

The survey on attitudes in society regarding the organisation of tourist trips for PwD confirmed conclusions from the analysis of the practical implications of various disability models in the creation of tourism supply that a single universal, optimal solution does not exist. All of the described MD can be applied in the development of a diverse tourism supply. The proposed model “diversification of supply […]” is the theoretical basis for the conscious development of accessible tourism in practice which in accordance with changes observed in the tourism market is undergoing increasing diversification and personalisation.

In each of the tourism supply for PwD types the economic model of disability based on the identification of PwD needs and surrounding society is important. The number of PwD and the scope of necessary services, social support (PwD often travel accompanied by one to three people) is determined by income in all the sectors identified in the structure of tourism supply. From the economic point of view, awareness of different types of disability and the diverse models describing it are significant aids in the segmentation of tourism supply and placement of products accessible to PwD on the tourism market.

The paper presents a new, critical perspective on the selected MD, the key to which is the search for optimal solutions in the development of accessible tourism. The analysis performed indicated the need for a synthesis of paradigms at the core of the conceptualisation of particular models, including those often regarded as being contrary (medical and social). The results of studies would give tourism providers important data on an increasingly competitive tourism market, and also affect changes in how PwD, the elderly, are viewed, from the category of “relatively poor” to “attractive, using a wide range of services”.

Health in low-income countries has become associated with the provision of minimum guaranteed public health services though Essential Health Packages (EHPs). How far do EHPs deliver the human right to health for all? This study addresses this question through qualitative research into access to health care for vulnerable communities, using Malawi as a case study. This study shows that there are significant accountability gaps and perceptions of weak service provision in Malawi’s EHP in relation to some particularly marginalised (and stigmatised) groups that limit the right to health and the promise of “health for all”.

This study extends the body of qualitative work on EHPs in general and on Malawi in particular by exploring the perceptions of key stakeholders in relation to inclusivity and the delivery of health policies to particularly vulnerable groups. To do so, this study adopted an approach based on interpretive epistemologies (Scott, 2014). This study conducted largely unstructured interviews with a range of health stakeholders, speaking to stakeholders individually, rather than through focus groups due to the potentially sensitive nature of the topic.

The findings of this study are as follows: limited inclusion of civil society actors and local communities; local communities and local policymakers feel frustration with the gap between the promises of consultation in the EHP and the reality, and the difficulties of not having effective channels of communication; and exclusionary health practices for particularly vulnerable groups.

There are limitations based on the qualitative methodology, and in terms of the particularly vulnerable groups – the authors studied two such groups (people with disabilities and those who identify as LBTQ) but a wider survey of vulnerable groups is needed to extend and confirm the findings.

Greater attention to the health rights of vulnerable groups would improve access and services, even in the context of resource restrictions. This study suggests that a deeper engagement with human rights-based approaches would pay dividends in terms of increasing access to health in Malawi, even within the constraints of the EHP process. Furthermore, without this, there is the risk that discrimination and exclusion will become more embedded in health policies, rather than progressively minimised.

Without addressing these issues, there is the risk that discrimination and exclusion will become more embedded in health policies, rather than progressively minimised.

This paper makes an important contribution to the growing literatures on EHP in sub-Saharan Africa and Malawi in particular and to the importance of listening to stakeholder perceptions. It provides original data on stakeholder perspectives of the challenges associated with universalising health care in resource-constrained countries. To the best of the authors’ knowledge, it is one of the first papers to focus on the rights of disabled and LBTQ people in relation to EHPs.