BACKGROUND Children with disabilities (CwDs) make up around 150 million of the billion people with disabilities in the world. The Sub-Saharan African countries have a large number of CwDs who have limited access to healthcare and rehabilitation care. This, combined with chronic poverty, low education, and inadequately trained healthcare professionals, substantially lowers these children's quality of life. The main objective of this scoping review was to discover the barriers and facilitators to healthcare access for CwDs in selected low to middle income Sub-Saharan African countries. As African countries significantly vary in socioeconomic status, we only focused on countries in Sub-Saharan Africa who allocated less than $50/person to healthcare. METHODS A broad and iterative search strategy using multiple sources and databases including CINAHL, Medline, Global Health, and Embase were utilized. Using a comprehensive search strategy, 704 articles were generated. After removal of the duplicates, 466 of them were screened based on the study inclusion and exclusion criteria. After iterative reading and screening of these articles, a final 15 articles were included in this review. RESULTS This scoping review shows that CwDs in the selected Sub-Saharan African countries face major barriers including stigma and negative attitudes, poverty and insufficient resources, inadequate policy implementations, physical inaccessibility, lack of transportation, lack of privacy, and inadequately trained healthcare professionals to deal with disability. Emotional and social support, including peer support for CwDs and caregivers, were identified as facilitators for better access to health services. CONCLUSIONS There is limited access to healthcare services in the low and middle income Sub-Saharan African countries due to poverty, low education, inadequate healthcare systems, and shortage of healthcare professionals. It is evident that there are socioeconomic, cultural, and physical related impediments that affect CwDs' and their caregivers' access to the required healthcare services. Policy development, improved physical accessibility, public disability awareness, and parental support are some of the key facilitators to access healthcare services. The study highlights the importance of revisions to childhood disability and healthcare provisions policy and practice as well as sustainable rehabilitation programs. Further research is required to explore ways to improve experience of accessing health services.

中文翻译：

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撒哈拉以南非洲中低收入国家的残疾儿童获得医疗保健的障碍和促进者：范围界定审查。

背景技术在全球十亿残疾人中，残疾儿童（CwD）约占1.5亿。撒哈拉以南非洲国家拥有大量的CwD，他们获得医疗保健和康复护理的机会有限。再加上长期的贫困，低学历和训练有素的医疗保健专业人员，大大降低了这些孩子的生活质量。范围界定审查的主要目的是发现在中低收入的撒哈拉以南非洲国家中，CwD获得医疗保健的障碍和促进者。由于非洲国家的社会经济状况差异很大，因此我们仅关注撒哈拉以南非洲地区人均医疗保健费用低于50美元的国家。方法利用了广泛的迭代搜索策略，该策略使用了多个来源和数据库，包括CINAHL，Medline，Global Health和Embase。使用全面的搜索策略，生成了704条文章。删除重复项后，根据研究纳入和排除标准筛选了466个重复项。在反复阅读和筛选这些文章之后，本次审查最终纳入了15篇文章。结果该范围审查显示，所选撒哈拉以南非洲国家的CwD面临主要障碍，包括污名化和消极态度，贫穷和资源不足，政策实施不足，人身难以接近，交通运输不足，缺乏隐私以及训练有素的医疗保健专业人员不足处理残疾。情感和社会支持，包括对CwD和照料者的同伴支持被认为是促进更好地获得卫生服务的促进者。结论由于贫穷，教育程度低，医疗保健系统不足以及医疗保健专业人员短缺，中低收入的撒哈拉以南非洲国家获得医疗保健服务的机会有限。显然，存在与社会经济，文化和身体相关的障碍，影响到社区和他们的护理人员获得所需医疗保健服务的机会。政策制定，改善的身体可及性，公众残疾意识以及父母的支持是获得医疗保健服务的主要推动力。该研究强调了修订儿童残疾和医疗保健规定的政策和实践以及可持续康复计划的重要性。