Effectiveness of Health System Interventions to Improve Access to General Healthcare Services for People with Disabilities: A Global Evidence and Gap Map Protocol
Ashrita Saran, Arthemon Nguweneza, Sarah Young, Kevin Ouma Ojiambo, Tracey Smythe, Hannah KuperBackground
People with disabilities make up 1.3 billion of the world's population and encounter systemic barriers—financial, structural, informational, and attitudinal—that limit their access to healthcare services, resulting in lower utilization, poorer quality of care, and worse health outcomes. Despite a growing volume of relevant research, no comprehensive global evidence and gap map systematically maps health-system interventions across WHO health system building blocks aimed at improving healthcare access for people with disabilities.
Objectives
This Evidence and Gap Map will systematically map health-system interventions that influence access to healthcare for people with disabilities at the global level. Specifically, it will: (1) provide a comprehensive global evidence map of systematic reviews and impact evaluations organized by WHO health system building blocks (service delivery, workforce, financing, information systems, governance, and technologies) and Universal Health Coverage outcomes (utilization, financial protection, quality); (2) offer a practical decision-support tool for policymakers, NGOs, and funders seeking to design disability-inclusive strategies; and (3) highlight evidence clusters and gaps, identifying where robust studies exist and where critical knowledge is lacking.
Methods
This EGM follows Campbell Collaboration methodology and is grounded in disability-inclusive Universal Health Coverage perspectives. The map will include impact evaluations and systematic reviews of interventions aimed at improving access to general and mainstream health services for people with disabilities across all geographic and income settings and the life course. Screening will employ human reviewers supported by large language model-assisted decision support (validated to high agreement standards). Outcomes will be mapped against UHC access domains and coded using structured frameworks.
Research question
What evidence exists on the effectiveness of health-system interventions to improve access to healthcare for people with disabilities globally, and where are the major evidence gaps?
Implications
This EGM addresses a critical evidence gap by integrating disparate strands of evidence into a single, coherent health-systems framework and providing a transparent, policy-relevant foundation for disability-inclusive health-system decision-making globally.