BARRIERS AND FACILITATORS TO HEALTH SERVICE ACCESSIBILITY AND QUALITY OF LIFE FOR PARENTS OF CHILDREN WITH DISABILITIES IN THE WEST BANK

Abstract

Background: Access to healthcare is a basic human right. However, parents of children with developmental disabilities in the West Bank face many challenges related to healthcare accessibility within a politically and socioeconomically constrained setting. Parents of children with developmental disabilities may also experience reduced Quality of life (QoL) across multiple domains. Objectives: This study aimed to identify financial, geographic, institutional, social, and political barriers and facilitators related to healthcare accessibility among parents of children with developmental disabilities in the West Bank, evaluate parents’ QoL across the physical, psychological, social relationships, and environmental domains, and examine the association between sociodemographic characteristics and QoL domains. Method: A cross sectional study was conducted between February and June 2025 among 250 parents of children with developmental disabilities in Nablus and Ramallah, West Bank. Data were collected using a structured barriers and facilitators questionnaire along with the World Health Organization Quality of Life Questionnaire BREF (WHOQOLBREF). A combination of descriptive statistics, univariate analyses, and multivariate linear regression analyses were used to explore the relationship between sociodemographic characteristics of parents and QoL domains. Results: Results: Financial, political, and institutional barriers were the most frequently reported healthcare accessibility challenges. A total of 77.2% of parents reported inadequate financial support, while 60.8% reported political restrictions affecting healthcare accessibility. QoL scores showed moderate physical (57.0 ± 16.8), psychological (56.8 ± 17.6), and social relationships (61.4 ± 21.7) domain scores, whereas the environmental domain had the lowest mean score (42.8 ± 18.0). In the multivariate analyses, income was consistently associated with QoL across multiple domains, while gender, chronic illness, and place of residence were significantly associated with specific QoL domains.

Conclusion: In the West Bank, parents QoL may be affected by broader structural and contextual barriers to healthcare accessibility rather than individual factors alone. Therefore, strengthening financial support systems, improving healthcare service delivery, and reducing political and geographic challenges may help improve healthcare accessibility and better support families of children with developmental disabilities in politically and socioeconomically constrained settings. Keywords: healthcare accessibility, quality of life, parents, children with developmental disabilities, West Bank