Purpose: The World Disability Report highlighted the need for adequate access to health and
medical rehabilitation services for those with disability. Participants in a large community based
survey in a low-income area were asked questions relating to their use of health related
services. Method: Using random, cluster sampling a representative sample of 1083 households
in a deprived area of Cape Town were approached and 152 people with disability were
interviewed. Results: Those with disability were more likely to be male (2 ¼ 4.24, p ¼ 0.03) and
unemployed (2 ¼ 66.89, p40.001) compared to those without disability. The percentages
reporting unmet needs were respectively: 54% for home-based care; 34.5% for assistive devices,
28.9% for medical rehabilitation services; and 2.5% for health services. Those over 65 years of
age were less likely to have had the medical rehabilitation that they required (2 ¼ 8.00,
p ¼ 0.018). There were fewer respondents with sensory and language disorders but these
groups reported proportionately more unmet needs. The main problems with accessing
services included inadequate finances (71%) and transport problems (72%). Conclusion: It is
recommended that all efforts be expended to extend appropriate rehabilitation services,
including home based-care and appliances to those identified as having disability, particularly
to those older than 65 years. In addition, the services need to be affordable and accessible in
terms of suitable transport, particularly in the light of the high unemployment rate and the
large number of respondents with mobility problems.