Disability constitutes a significant public health and human rights concern worldwide, with profound implications in low and middle-income countries, including Nigeria. Globally, approximately 1.3 billion individuals, representing 16% of the population, experience significant disabilities, a figure projected to increase due to ageing populations and rising prevalence of noncommunicable diseases. In Nigeria, an estimated 6% of the population, or roughly 11 million people, live with disabilities, and one in ten households includes a member with a disability. Despite the magnitude of this population, persons with disabilities (PWDs) face persistent barriers in accessing health services, resulting in poorer health outcomes, limited service utilisation, and heightened exposure to preventable diseases and deaths.
There are myriad barriers to healthcare access for PWDs. For instance, many health facilities are inaccessible for PWDs; stairs are without ramps, narrow doorways, and toilets are often inaccessible. Furthermore, the absence of sign language interpreters, visual or hearing aids make visits difficult or impossible. For instance, audits of primary healthcare centres in Abuja showed that only a small fraction were fully wheelchair accessible, and none offered sign language interpretation or braille signage[3]. These infrastructural limitations prevent PWDs from accessing even basic healthcare services, effectively marginalising them from the health system. In addition, women and children with disabilities often face compounded barriers to maternal and reproductive health services. These challenges are rooted in deep-seated social assumptions, including the widespread belief that women with disabilities are asexual and therefore do not need sexuality education, contraception, or opportunities for motherhood. Such misguided perceptions reinforce exclusion from reproductive health information and services, including family planning, safe abortion care, HIV and STI testing, and prenatal and postnatal support. There is also persistent discrimination, stigma, and degrading treatment of PWDs, which shows that their rights are largely neither protected nor enforced. It is observed that both the women’s rights and disability rights movements have historically overlooked the specific concerns of women with disabilities, particularly around sexuality, reproductive autonomy, and parenting. Beyond social stigma and discrimination, women with disabilities face structural barriers such as limited adaptive services and a lack of tailored sexual and reproductive health information across all categories of disability.
Also, provider training and communication deficits further exacerbate these challenges. Healthcare workers often lack disability-sensitive training, resulting in inadequate communication, discriminatory practices, or paternalistic approaches in patient care. Providers often direct attention to caregivers rather than the patients themselves, undermining the autonomy and dignity of PWDs. Delayed diagnoses and limited access to preventive care are pressing problems, too.
Financial barriers are also significant. PWDs are disproportionately affected by poverty and underemployment, limiting their ability to cover out-of-pocket expenditures, which constitute more than 70% of Nigeria’s total health spending.
The Discrimination Against Persons with Disabilities (Prohibition) Act 2018 mandates equal access to healthcare and public infrastructure. However, implementation remains uneven, with few states and private facilities operationalising the provisions. Consequently, legal protections exist in theory but have a limited effect in practice, perpetuating systemic exclusion. Addressing the barriers faced by persons with disabilities in accessing healthcare in Nigeria requires a fundamental shift from the equal distribution of resources toward strategies that are equity-focused, taking into account the specific disadvantages experienced by this population. One critical area for intervention is the design of healthcare infrastructure. This includes the incorporation of ramps, accessible toilets, clear signage, and adjustable medical equipment. Equally important is the capacity building of healthcare providers. Integrating disability-sensitive training into both pre-service and in-service education programs can improve communication, promote respectful engagement, and equip providers with clinical approaches tailored to the needs of PWDs. Targeted subsidies, expanded health insurance coverage, and social protection programs can help alleviate out-of-pocket expenditures for medical care, transportation, and assistive devices and ensure that financial constraints do not prevent individuals from seeking timely and essential services. Also, public health campaigns should include PWDs, not as an afterthought but as central participants. But real change begins with society itself. Attitudinal shifts and efforts at destigmatisation are necessary.
Disability is not a tragedy, nor a limitation of potential; it is a part of human diversity. True inclusion means recognising the abilities, talents, and rights of persons with disabilities, and creating environments in schools, workplaces, public spaces, and healthcare that enable everyone to participate fully and equally. It requires challenging stigma, dismantling physical and attitudinal barriers, and ensuring that policies, services, and social norms reflect the value and dignity of all individuals, regardless of ability. Healthcare is one key area where PWDs must feel welcome, seen and cared for on an equal basis with others.
Over the years, CHELD has done significant work in disability, in particular in the area of mental health, promoting legal protections, providing material support and supporting policy development. Through its work on the right to health for all communities, CHELD continues to advocate for universal health coverage for PWDs.
CHELD recently joined the World Health Organization (WHO) Disability Health Equity Network, a global body which supports health equity for PWDs. This prestigious network brings together over 150 organisations from around the world to promote coordinated action aimed at closing the persistent and unjust health gaps experienced by PWDs. Through this network, CHELD can connect with a diverse coalition of stakeholders, including organisations of persons with disabilities, civil society groups, and member states, gaining access to global expertise, shared best practices, and collaborative strategies for mainstreaming disability in the health sector. This membership also strengthens CHELD’s efforts in Nigeria by supporting programs that integrate equity-driven approaches into healthcare policy, enhance inclusive service delivery, and align local initiatives with international standards.
Advancing disability-inclusive healthcare in Nigeria is not merely a technical challenge it is a moral, social, and developmental imperative. The barriers faced by persons with disabilities are deeply rooted in systemic neglect, attitudinal bias, and institutional failures that cannot be solved through piecemeal interventions. What is required is a deliberate shift toward equity-driven approaches that recognise disability not as a deficit, but as part of human diversity deserving dignity, respect, and tailored support. Transforming the health system begins with acknowledging that PWDs have the same rights to information, autonomy, and quality healthcare as everyone else. Inclusive infrastructure, meaningful provider training, financial protection, and research tailored to disability realities must move from rhetoric to practice. Equally, society must confront discriminatory norms, especially those affecting women and children with disabilities, to ensure that reproductive choices, parenting, and bodily autonomy are recognised and upheld. Real progress, however, will depend on the collective will of government actors, civil society, service providers, and communities themselves. Disability-inclusive healthcare is achievable but only if equity is embedded as a guiding principle rather than an afterthought.