Photovoice Analysis of Healthcare Access Challenges among Women Living with Disability’s in Nairobi’s Informal Settlement during the COVID-19 Pandemic

Abstract

The COVID-19 pandemic exposed greatly existing health care inequalities experienced by persons living with disabilities. Many persons living with disabilities in Kenya’s informal areas experienced numerous inequalities during the COVID-19 pandemic, and this was exhibited in their difficulty accessing employment as a result of mass layoffs, education, and health services. This qualitative study explored the health and well-being of women living with disabilities in informal settlements in Nairobi during the COVID-19 pandemic. The photovoice technique was used to collect data from six purposively sampled participants that represented the vulnerable persons with disabilities living in the informal settlements of Korogocho and Viwandani in Nairobi. Additionally, in-depth interviews (IDIs) were conducted to further highlight how common the experiences described by the Photovoice participants were. Recordings were transcribed verbatim, translated to English, and coded using NVivo. Through thematic analysis of the transcripts, three main barriers were identified: challenges with access and affordability of health services for women living with disability; social and self-stigma as a contributing factor in access to health services for women living with disability; and the built and physical environment as a challenge in access to healthcare services for women living with disability. Attitudinal factors were explored, and unfavorable health-seeking behavior was found to be a barrier to access to healthcare for some participants during the pandemic.