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Pediatr Neonatal Nurs Open J. 2022; 8(1): 1-13. doi: 10.17140/PNNOJ-8-134 Eta VEA intellectual ability.14 The signs and symptoms of depression may include continuing feelings of sadness, no longer showing interest in his/her desired activities, displaying poor hygienic practices, irritability as well as feeling insignificant and desperate. Severe symptoms of depression are recurrent thoughts of death and/or suicidal tendency.42 CHALLENGES FACED BY INDIVIDUALS WITH DISABILITIES IN ACCESSING APPROPRIATE MEDICAL HEALTH SERVICES Persons with disabilities face many barriers in accessing and utilizing quality healthcare services. This may be due to the fact that most of the healthcare facilities are costly, sometimes not available and not disability friendly.43 Also, the challenges are usually due to stigmatization and discrimination which are associated with their impairments and differences in race or ethnicity among others. The challenges range from inaccessible physical environments, the lack of the appropriate healthcare providers who can render adequate care to persons with autism to inflexible policies and procedures, social assumptions and prejudices. Furthermore, it was found that parents of children with autism faced unique challenges in accessing referrals and specialized care services.4,44 The following sub-sections describe these challenges and/or the barriers to accessing and receiving quality healthcare by persons with disabilities in general and autism in particular and state World Health Organization (WHO) as well as United Nations (UN’s) strategies for reducing the challenges. LIMITED AVAILABILITY OF HEALTH SERVICES, IN ACCESSIBLE PHYSICAL ENVIRONMENTS AND EQUIPMENT Usually, the architectural designs of most health facilities are not disability friendly; they are not well adapted to suit persons with disabilities. As a result, they cannot fully access the structure with their wheelchairs or crutches and circulate freely from one section to another. This prevents persons with disabilities to fully utilize healthcare services resulting in low quality care.8 It has been documented that most primary care facilities in California do not have accessible healthcare equipment such as weight scales, examination tables, cancer screening equipment and wheelchairs, to move safely and with ease within the health facility.45 This is true for almost all healthcare facilities in developing and underdeveloped countries where appropriate health services for persons with disabilities are scarce or very limited. Individuals with disabilities particularly those in rural and remote areas experience high unmet needs for healthcare. In addition, parents of children with developmental disabilities have reported a range of barriers to accessing healthcare services.46 These include among others the absence of accurate information regarding available services, misconceptions regarding medical care and the aim of treatment, communication and transportation difficulties as well as fear of stigmatization and discrimination. The absence of appropriate health services and accessible equipment in many outpatient provider offices leads to fewer preventive investigations, missed diagnoses, and delayed care particularly, for individuals with mobility impairments. For instance, most ladies with mobility difficulties do not access breast and cervical cancer screening examinations because the available equipment are not adapted to accommodate women with disabilities.6 This unequal access to some health facilities’ buildings by persons with disabilities due to narrow doorways, no pavements, inappropriate office and bathroom facilities, and inaccessible parking areas as well as inaccessible medical equipment create barriers to the full access of healthcare facilities. INADEQUATE SKILLS AND KNOWLEDGE OF HEALTH WORKERS AND TREATMENT DECISIONS CHALLENGES Due to the lack of trained healthcare providers regarding autism parents having children with autism may face major difficulties discussing treatment options with their child’s healthcare provider. These challenges may include among others communication difficulties, lack of knowledge on the part of the healthcare provider regarding specific
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