Inclusion of vulnerable groups in health policies: Regional policies on health priorities in Africa.

BACKGROUND: If access to equitable health care is to be achieved for all, policy documents must mention and address in some detail different needs of groups vulnerable to not accessing such health care. If these needs are not addressed in the policy documents, there is little chance that they will be addressed at the stage of implementation. OBJECTIVES: This paper reports on an analysis of 11 African Union (AU) policy documents to ascertain the frequency and the extent of mention of 13 core concepts in relation to 12 vulnerable groups, with a specific focus on people with disabilities. METHOD: The paper applied the EquiFrame analytical framework to the 11 AU policy documents. The 11 documents were analysed in terms of how many times a core concept was mentioned and the extent of information on how the core concept should be addressed at the implementation level. Each core concept mention was further analysed in terms of the vulnerable group in referred to. RESULTS: The analysis of regional AU policies highlighted the broad nature of the reference made to vulnerable groups, with a lack of detailed specifications of different needs of different groups. This is confirmed in the highest vulnerable group mention being for 'universal'. The reading of the documents suggests that vulnerable groups are homogeneous in their needs, which is not the case. There is a lack of recognition of different needs of different vulnerable groups in accessing health care. CONCLUSION: The need for more information and knowledge on the needs of all vulnerable groups is evident. The current lack of mention and of any detail on how to address needs of vulnerable groups will significantly impair the access to equitable health care for all.

Gender differences in HIV knowledge and unsafe sexual behaviours among disabled people in South Africa.

PURPOSE: The international literature suggests that disabled people may be at increased risk for HIV infection. There is a growing increasing recognition of this in South Africa, although there remains a paucity of literature on how disabled people are affected by HIV/AIDS. This is a concern given the seriousness of the epidemic here. This paper reports on descriptive data exploring gender differences in HIV knowledge and unsafe sexual behaviours among disabled individuals in South Africa. METHOD: Data was collected by means of a survey questionnaire from a total sample of 285 disabled individuals in three of the nine provinces in South Africa. Data was analysed by means of descriptive statistics. RESULTS: There are low levels and uncertainty of knowledge about HIV transmission and HIV prevention, with females tending to have lower levels of knowledge than males. Although the importance of condoms in HIV prevention was recognised, there were relatively high levels of reported unsafe sexual behaviours. Males reported higher number of monogamous and concurrent sexual partnerships and sex without a condom after alcohol use. CONCLUSIONS: The results support the literature that suggests that disabled people are at risk for HIV infection, and that both male and female individuals with disability are at risk.