A Glimpse of Disability Inclusive Accessible SRHR in Bangladesh
In Bangladesh, the Constitution is the Supreme Law of the Republic. Article 7 of the Constitution ensures its supreme power and warrants that every law of this country has to be enacted in compliance with the Constitution. Whereas the preamble of the Constitution ensures that rule of law, fundamental human rights and freedom, equality and justice, political, economic, and social rights shall be secured for all citizens, Article 15(d) of the Constitution specifically mentions the right to social security, that is to say, to public assistance in cases of undeserved want arising from unemployment, illness or disablement, or suffered by widows or orphans or in old age, or in other such cases. Also, the Persons with Disabilities Rights and Protection Act 2013 has emphasized the necessity of dedicated surveys and proper data on the prevalence of disability in its “Detection” section.
The Government of Bangladesh, as part of its inclusivity initiatives, has enacted the Rights and Protection of Persons with Disabilities Act 2013 as a logical follow up of ratifying the Convention. The Rights and Protection of Persons with Disabilities Act 2013 has repealed the Disability Welfare Act 2001 through its Section 44(1). The act establishes the right of Persons with Disabilities to live in a healthy environment. It states that depending on the type of disability, quality medical services, and health care facilities must be provided to Persons with Disabilities. It prohibits discrimination against Persons with Disabilities; and also empowers them to make complaints to the District Committee against any discrimination faced while availing health care services and to claim compensation. The Act addresses aspects of food security and nutrition for disabled children and adults. It requires the state to take preventive measures to lower the risk of factors responsible for causing disabilities among children and women and to reduce their medical expenses. It also calls for use of accessible modes of communication in all hospitals and medical institutions including sign language interpretation or employment of speech-language therapists where deemed necessary. Under the Act, all aspects of accessibility and mobility is to be ensured for Persons with Disabilities in medical and health care institutions. Lastly, Schedule 11(Kha) of the Act specifies that the State should encourage insurance companies to set up separate insurance for Persons with Disabilities to increase their social security.
Under the National Health Policy (NHP) 2011, the State is committed to providing unrestricted access to health care services and other medical services without discrimination and to raise widespread awareness on nutrition, health hazards, and available health care services to ensure a healthy and balanced lifestyle for Persons with Disabilities. It also stated that free healthcare and services shall be provided for the poor and the disadvantaged members of the society, which especially benefits financially disadvantaged Persons with Disabilities.
The Sixth Five Year Plan FY 2011 – FY 2015 requires that relevant authorities shall make early detection of symptoms of disability, primary medical rehabilitation, undertake a nutrition program for pregnant women, appoint trainee doctors, nurses, and other caregivers to deal with disability issues and introduce support services for use of assistive devices and equipment at health centers.
However, in these laws, many gaps are preventing the proper inclusion of persons with disabilities in the health sector. Such as, firstly, there are no monitoring mechanisms to oversee compliance with health standards and guidelines for public health care services and facilities for persons with disabilities. Secondly, there is no provision in the various plans for raising public awareness about the plan provisions; persons with disabilities are largely, therefore, unaware of their various health entitlements. Thirdly, there is no separate budget allocated for persons with disabilities relating to health. Fourthly, the Sixth Five Year Plan is silent on the need to develop a physical rehabilitation system, although the Disability Rights Act provides for the adoption of family and community-based rehabilitation through private initiatives, establishment of institutions to enable rehabilitation especially for the intellectually disabled, and setting minimum standards of care depending on the type and nature of the disability.