Disability inclusion in Zambia's government COVID-19 policies: a framework analysis.

BACKGROUND: People with disabilities experienced disproportional health risks and systematic exclusion during the COVID-19 pandemic with particularly severe consequences such as poorer health outcomes and barriers to services in countries around the world. In Zambia, people with disabilities experienced income loss, stress, and additional barriers to accessing health services. This study aimed to analyse disability inclusion in national COVID-19 policies in Zambia. METHODS: We conducted content policy analysis using framework analysis. Ten documents were analysed against eight equity-relevant dimensions of a typical disability inclusive, COVID-19 crisis response. We adapted the framework from Sakellariou and used Ritchie and Spencer's five step thematic analysis. These national policies were published between March 2020 and December 2023. The documents were also scored against eight themes for policy provisions. RESULTS: Disability inclusion was generally low. Although action was provided for disability inclusion in relation to accessible information, access to healthcare and education, financial support, and considerations for the needs of people facing multiple exclusion, information was often not detailed and did not cover all people with disabilities. Several themes on disability inclusion were neglected, including reasonable accommodation and disaggregated disability data. CONCLUSION: These findings underscore persistent structural barriers to equity for people with disabilities during public health crises. It highlights shortcomings by the Government of Zambia in promoting disability inclusion during the COVID-19 pandemic. There is need for improved provisions across all stages of policy design and implementation to strengthen equity and resilience in future public health emergencies.