Targeted Reforms Needed to Bridge Gaps in Social Health Protection for Persons with Disabilities in Southeast Asia

Despite progress in expanding social health protection schemes, significant gaps remain that prevent equitable benefits for this vulnerable population.

A recent report from the International Labour Organization (ILO), titled “Fostering Inclusion: Advancing Social Health Protection for Persons with Disabilities in Cambodia, the Lao People’s Democratic Republic, and Viet Nam”, underscores the urgent need for reforms to improve healthcare access for persons with disabilities in the region. Despite progress in expanding social health protection schemes, significant gaps remain that prevent equitable benefits for this vulnerable population.

Healthcare Challenges for Persons with Disabilities

Persons with disabilities often face greater healthcare needs, translating into higher costs and poorer outcomes when protection systems fall short. The report highlights that although all three countries have made legal commitments to uphold healthcare rights for persons with disabilities, these rights are not adequately integrated into the governing frameworks of social health protection systems.

In Cambodia, for instance, less than half of the population is covered by social health schemes, although persons with disabilities are better represented within this group. Meanwhile, Viet Nam and Lao PDR have achieved over 90% population coverage due to their comprehensive legal frameworks, yet gaps in benefit packages and accessibility continue to pose challenges.

Key Findings from the Report

1. Population Coverage: Universal coverage is critical for equitable access. Viet Nam and Lao PDR have established near-universal social health protection but need to address the specific needs of persons with disabilities. Cambodia lags in overall population coverage, reflecting broader systemic issues.
2. Financial Barriers: Persons with disabilities often incur higher out-of-pocket healthcare costs due to insufficient benefits and limited availability of disability-specific services.
3. Service Gaps: A lack of investment in rehabilitation services, assistive devices, and long-term care frameworks limits effective healthcare access.
4. Systemic Barriers: Poor service quality, inaccessible facilities, and complex administrative processes hinder healthcare equity.

Actionable Recommendations

The report provides a roadmap to address these challenges through comprehensive reforms, including:

• Expanding Universal Coverage: Remove means-testing for persons with disabilities to ensure inclusivity in social health protection.
• Enhanced Benefit Packages: Integrate disability-specific services, including rehabilitation and assistive devices, into standard healthcare benefits.
• Inclusive Policymaking: Engage persons with disabilities and their representative organizations in designing and implementing healthcare policies.
• Strengthening Certification Systems: Improve disability certification to ensure accurate eligibility assessments.
• Investing in Accessibility: Increase funding for rehabilitation centers, assistive technology, and accessible healthcare infrastructure.
• Improving Long-Term Care: Develop frameworks to address the unique and ongoing needs of persons with disabilities.

A Call for Inclusive Reforms

“Persons with disabilities often face higher healthcare needs and costs, yet they remain underserved by existing protection systems. Inclusive reforms are vital to ensure that no one is left behind in the journey toward universal health coverage,” said Marielle Phe Goursat, ILO Project Manager.

A Vision for the Future

The report aligns with global commitments under the United Nations’ Sustainable Development Goals (SDGs), particularly Goal 3 (Good Health and Well-being) and Goal 10 (Reduced Inequalities). By implementing the recommended reforms, Cambodia, Lao PDR, and Viet Nam can create inclusive healthcare systems that prioritize equity, dignity, and access for all.

Additional Insights

The ILO emphasized that fostering inclusion will not only improve the lives of persons with disabilities but also strengthen the broader healthcare system by making it more resilient, accessible, and sustainable. These changes are part of a larger effort to achieve universal health coverage and reflect the region’s commitment to social justice and human rights.

The report serves as both a wake-up call and a guide for governments, policymakers, and international organizations to accelerate efforts toward truly inclusive health systems in Southeast Asia.