Access to Health Services as a Determinant of Social Inclusion Among Persons with Disabilities in Pakistan

Access to Health Services as a Determinant of Social Inclusion Among Persons with Disabilities in Pakistan | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Access to Health Services as a Determinant of Social Inclusion Among Persons with Disabilities in Pakistan Shakeel Ahmad, Asad Ullah, Mr. Sikandar Khan This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8855055/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 11 You are reading this latest preprint version Abstract Background The study aims to analyze the social inclusion of persons with disabilities in the context of their access to adequate health services. Methods A multistage stratified-random sampling was adopted to collect data from a sample of 488 Persons with Disabilities (PWDs). Chi-square and Kendall’s Tau-b tests were used to determine the level and direction of association among variables. Access to adequate health-services enhanced the social inclusion of literate PWDs at a higher rate than illiterate. Results PWDs who admitted that accommodation was available for them at health institution 62.4 percent were socially included, compared to 25.1 percent of those for whom the facility was not available. Those PWDs who consider that they were able to afford the cost of visit and medicines 58.1 percent were socially included, compared to 28.4 percent of those who were unable to afford it. The logistic regression model based on its calculated coefficients explained that; social inclusion of PWDs is more likely to occur when PWDs have high family monthly income (EXP B = 2.602), high literacy rate (EXP B = 2.280), have better access to health (EXP B = 2.254 ) . In contrary, change in family from joint to nuclear family reduced the likelihood of social inclusion of PWDs (EXP B = -1.002). Conclusion Implementation of building codes in the construction of public buildings and offices to facilitate smooth mobility of PWDs in, hospitals and public places, etc. along with ease in use of all facilities available in the health center. Literacy status adequate health services person with disabilities family monthly income family type Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 07 May, 2026 Reviewers agreed at journal 28 Apr, 2026 Reviews received at journal 26 Apr, 2026 Reviews received at journal 21 Apr, 2026 Reviewers agreed at journal 09 Apr, 2026 Reviewers agreed at journal 06 Apr, 2026 Reviewers invited by journal 06 Apr, 2026 Editor invited by journal 16 Mar, 2026 Editor assigned by journal 14 Mar, 2026 Submission checks completed at journal 11 Mar, 2026 First submitted to journal 11 Mar, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8855055","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":620079023,"identity":"0ebce6b1-4188-4b39-af56-3db3faeb7a59","order_by":0,"name":"Shakeel Ahmad","email":"","orcid":"","institution":"Hazara University","correspondingAuthor":false,"prefix":"","firstName":"Shakeel","middleName":"","lastName":"Ahmad","suffix":""},{"id":620079024,"identity":"6ae89656-b7fc-4ac2-9e60-a681ef37fd0c","order_by":1,"name":"Asad Ullah","email":"","orcid":"","institution":"The University of Agriculture, Peshawar","correspondingAuthor":false,"prefix":"","firstName":"Asad","middleName":"","lastName":"Ullah","suffix":""},{"id":620079025,"identity":"5ec3a9a2-b9af-45dc-a7a3-8073736e49e6","order_by":2,"name":"Mr. Sikandar Khan","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA9UlEQVRIiWNgGAWjYDACZjYgAcQSEkD6YwNIKAGIDxCphXEmUVoYkLQw8xKjRb6dLfFzQZldvuTs5mePbXccZuBnzzFgLjiDW4vBYbbD0jPOJVvOljlmbpx75jCDZM8bA+YZN/BoYWZvkOZtYzaQk0gwk85tO8xgcANoC88HPA5rZm/+zdtWD9SS/k3aEqjFnpAWhsNsx4C2HDaQlsgxk2YE2SIB0oLPYYfZ0qx5zh03kJyRUybZ25bOI3HmWcHhGXi8L99/zPg2T1m1gcSN9G0SP9us5fjbkzc+LjiGx2HogAfsWhI0QAEz6VpGwSgYBaNgGAMApERK/O2sVMYAAAAASUVORK5CYII=","orcid":"","institution":"Hazara University","correspondingAuthor":true,"prefix":"Mr.","firstName":"Sikandar","middleName":"","lastName":"Khan","suffix":""}],"badges":[],"createdAt":"2026-02-11 19:08:23","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8855055/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8855055/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":106725933,"identity":"ef78485f-ec8e-4840-b551-95f947c468b0","added_by":"auto","created_at":"2026-04-12 18:34:33","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":484490,"visible":true,"origin":"","legend":"","description":"","filename":"PWDsPaper2026.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8855055/v1_covered_434d2918-e411-4f03-bc9c-a09abd2c74b1.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Access to Health Services as a Determinant of Social Inclusion Among Persons with Disabilities in Pakistan","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"discover-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Discover Public Health](https://link.springer.com/journal/12982)","snPcode":"12982","submissionUrl":"https://submission.springernature.com/new-submission/12982/3","title":"Discover Public Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Literacy status, adequate health services, person with disabilities, family monthly income, family type","lastPublishedDoi":"10.21203/rs.3.rs-8855055/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8855055/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eThe study aims to analyze the social inclusion of persons with disabilities in the context of their access to adequate health services.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA multistage stratified-random sampling was adopted to collect data from a sample of 488 Persons with Disabilities (PWDs). Chi-square and Kendall\u0026rsquo;s Tau-b tests were used to determine the level and direction of association among variables. Access to adequate health-services enhanced the social inclusion of literate PWDs at a higher rate than illiterate.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003ePWDs who admitted that accommodation was available for them at health institution 62.4 percent were socially included, compared to 25.1 percent of those for whom the facility was not available. Those PWDs who consider that they were able to afford the cost of visit and medicines 58.1 percent were socially included, compared to 28.4 percent of those who were unable to afford it. The logistic regression model based on its calculated coefficients explained that; social inclusion of PWDs is more likely to occur when PWDs have high family monthly income (EXP B\u0026thinsp;=\u0026thinsp;2.602), high literacy rate (EXP B\u0026thinsp;=\u0026thinsp;2.280), have better access to health \u003cem\u003e(EXP B\u0026thinsp;=\u003c/em\u003e\u0026thinsp;2.254\u003cem\u003e)\u003c/em\u003e. In contrary, change in family from joint to nuclear family reduced the likelihood of social inclusion of PWDs (EXP B = -1.002).\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eImplementation of building codes in the construction of public buildings and offices to facilitate smooth mobility of PWDs in, hospitals and public places, etc. along with ease in use of all facilities available in the health center.\u003c/p\u003e","manuscriptTitle":"Access to Health Services as a Determinant of Social Inclusion Among Persons with Disabilities in Pakistan","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-04-10 15:18:01","doi":"10.21203/rs.3.rs-8855055/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-05-07T05:35:03+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"248095749652726015720449305653655985911","date":"2026-04-28T13:37:29+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-04-26T09:11:31+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-04-21T15:50:55+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"337281309606873976698035251770235663825","date":"2026-04-09T04:40:59+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"295939150509355696247375248516168286035","date":"2026-04-07T03:58:32+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-04-06T17:27:04+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-03-16T17:28:33+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-03-14T05:47:07+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-03-12T03:24:28+00:00","index":"","fulltext":""},{"type":"submitted","content":"Discover Public Health","date":"2026-03-11T20:06:44+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"discover-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Discover Public Health](https://link.springer.com/journal/12982)","snPcode":"12982","submissionUrl":"https://submission.springernature.com/new-submission/12982/3","title":"Discover Public Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"60b7a1ee-62f8-44d4-abdc-04c7ccfd9244","owner":[],"postedDate":"April 10th, 2026","published":true,"recentEditorialEvents":[{"type":"editorInvitedReview","content":"","date":"2026-05-07T05:35:03+00:00","index":62,"fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-04-10T15:18:01+00:00","versionOfRecord":[],"versionCreatedAt":"2026-04-10 15:18:01","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8855055","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8855055","identity":"rs-8855055","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}