Modifying homes for persons with physical disabilities in Thailand

PROBLEM: Thailand passed the Persons with Disabilities Empowerment Act in 2007. The Act, which is in compliance with the United Nations Convention on the Rights of Persons with Disabilities, ensures that registered persons with disabilities are entitled to home environment modifications’ benefits up to a maximum of 20 000 baht (670 United States dollars); however, the Act’s enforcement is still weak in Thailand. APPROACH: In 2013, researchers developed a home modification programme, consisting of a multidisciplinary team of medical and nonmedical practitioners and volunteers, to modify homes for persons with disabilities. The programme recruited participants with physical disabilities and assessed their functioning difficulties. Participants’ homes were modified to address identified functioning difficulties. LOCAL SETTING: The project was implemented in four provinces in collaboration with staff from 27 district hospitals located in north-eastern Thailand. RELEVANT CHANGES: After the home modifications, all 43 recruited participants reported reduced difficulties in all areas, except for participants with severe degrees of difficulties, such as those reporting being unable to walk and unable to get up from the floor. The participants’ quality of life had also improved. The average EQ-5D-5L score, measuring quality of life, increased by 0.203 – from 0.346 at baseline to 0.549 after the modifications. LESSONS LEARNT: Home modifications in low-resourced settings are technically and financially feasible and can lead to reducing functioning difficulties and improving the quality of life of persons with disabilities. Implementation requires government subsidies to finance home modifications and the availability of technical guidelines and training on home modifications for implementing agents.