Western Cape: Disabled Adult Nappy Policy Inadequate, Causes Strain

• Disabled individuals in the Western Cape report receiving insufficient adult nappies from clinics, forcing them to use disability grants for additional purchases.
• Advocacy group Disability Revolution has been requesting a clear policy on incontinence product provision from the Western Cape Department of Health and Wellness and the City of Cape Town since 2023.
• The Western Cape Department of Health states its policy is to supply a maximum of three products per day for up to six months and has developed an SOP and eligibility tool, which are not yet public.
• The City of Cape Town assesses needs via clinicians and is working to align its provision with provincial policy, offering reassessments and delivery options.
• Advocates express disappointment over the three-year delay in making a transparent adult nappy policy publicly available, raising concerns about disabled persons' rights to essential supplies.

The current lack of clear, publicly available policy creates potential grounds for human rights litigation or administrative challenges regarding equitable access to essential healthcare supplies for disabled persons.

Disabled individuals in the Western Cape are facing significant challenges in accessing adequate adult incontinence products, leading to financial strain and compromised well-being. Angel, a resident of Eerste River, Cape Town, who has used a wheelchair since being shot in 2015, requires adult nappies constantly. She currently receives two packs of 14 nappies each month from the Kleinvlei Community Health Clinic, a quantity she finds severely insufficient for her needs. This forces her to allocate a portion of her disability grant to purchase additional supplies, money she states could otherwise be used for her children or other essential expenses.

Angel's personal requirements highlight the inadequacy of the current provision; she notes that due to high water intake, frequent urination, and occasional diarrhea, she ideally needs two packs per week, equating to four packs monthly. A recent clinic appointment in August saw her provided with 12 packs, intended to last until January 28, 2027, a period she knows is unrealistic given her daily needs. Similarly, Othandwayo Rangula, another wheelchair user, receives two packs of 14 adult nappies monthly from the Mfuleni clinic, also reporting this amount as insufficient. Advocacy group Disability Revolution has highlighted that many disabled persons in South Africa find themselves in comparable situations, often receiving only one pack of 10 to 15 nappies per month, which is far from adequate. A market assessment revealed that a single pack of 10 nappies can cost between R120 and R190, depending on the brand, size, and retailer, underscoring the substantial financial burden on individuals.

In response to concerns, the Western Cape Department of Health and Wellness has stated its policy is to provide a maximum of three incontinence products per person per day, for a period of up to six months. The department also indicated that it has developed a standard operating procedure for the provision of adult incontinence products. This procedure is complemented by a provincial eligibility assessment tool, designed to standardize criteria for eligibility and recommendations for product allocation. Both the procedure and the tool are awaiting approval and circularization before they can be made publicly available.

The City of Cape Town, through Mayco member for community services and health Francine Higham, explained that clients undergo assessment by a clinician to determine the appropriate provision of products. The City is actively engaging with the Western Cape Department of Health and Wellness to align its approach with the provincial policy, aiming for greater consistency in service delivery. Higham confirmed that the City is working towards establishing a written guideline that will cover eligibility, assessment, and provision based on clinical need. She also assured that products are provided free of charge, no client with an assessed need is refused, and City facilities have sufficient stock without shortages this financial year. Clients who find the quantity insufficient are encouraged to seek reassessment at their facility, where clinicians can increase the allocation if a greater need is established. For those facing travel barriers, City Health offers to arrange delivery through its Community Health Worker service.

The ongoing lack of a clear, publicly accessible policy on adult nappy provision for disabled persons in the Western Cape has drawn criticism from advocacy groups. Disability Revolution, which represents people with disabilities, formally addressed the Western Cape Department of Health and Wellness and the City of Cape Town in a letter on September 18, highlighting the inadequate provision. The organization has been seeking information regarding the policy on incontinence products since 2023, indicating a prolonged period of engagement without resolution.

Adam Narain, a senior researcher from #UniteBehind, an advocacy group collaborating closely with Disability Revolution, expressed disappointment that after three years of inquiries, a publicly available policy on the provision of nappies remains elusive. This situation underscores a critical gap in the support system for disabled persons rights in South Africa. The absence of a transparent and standardized Western Cape adult nappy policy for disabled individuals creates potential grounds for human rights litigation or administrative challenges, particularly concerning equitable access to essential healthcare supplies for disabled persons. Lawyers and compliance officers should monitor the development and circularisation of the Western Cape's standard operating procedure and eligibility assessment tool for adult incontinence products, as the current lack of clear, publicly available policy creates potential grounds for human rights litigation or administrative challenges regarding equitable access to essential healthcare supplies for disabled persons.

Lawyers and compliance officers should monitor the development and circularisation of the Western Cape's standard operating procedure and eligibility assessment tool for adult incontinence products, as the current lack of clear, publicly available policy creates potential grounds for human rights litigation or administrative challenges regarding equitable access to essential healthcare supplies for disabled persons.

Source: Original reporting via GroundUp