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Effect of Disability-Inclusive Health Education on Disability-Inclusive Practice Knowledge among Public Health Students in Nigeria

Abstract

Disability-inclusive healthcare is an important component of equitable public health practice because persons with disabilities may experience physical, communication, social, financial, and institutional barriers when accessing health services. Public health professionals require adequate knowledge of disability-inclusive approaches to ensure that health programmes, communication strategies, facilities, and services are accessible and responsive to the needs of people with different disabilities. However, limited exposure to disability-inclusive health education, inadequate understanding of accessibility requirements, and insufficient practical experience with persons with disabilities may affect the ability of public health students to recognize and apply inclusive practices. Disability-inclusive health education provides an opportunity to strengthen students' knowledge of accessible and equitable approaches to public health practice. Against this background, this study investigates the effect of disability-inclusive health education on disability-inclusive practice knowledge among public health students in Nigeria. The study will be anchored on the Social Model of Disability, Social Cognitive Theory, and Health Belief Model. The Social Model of Disability emphasizes that disability-related disadvantage is influenced not only by individual impairments but also by physical, social, communication, and institutional barriers within society. Social Cognitive Theory explains how observational learning, practical modelling, self-efficacy, feedback, and experiential activities may influence students' understanding and adoption of disability-inclusive practices. The Health Belief Model explains how perceptions of barriers, benefits, susceptibility to exclusion-related health risks, and cues to action may influence students' willingness to apply inclusive approaches in public health practice. Collectively, these theoretical perspectives provide a suitable framework for explaining how disability-inclusive health education may influence disability-inclusive practice knowledge among public health students in Nigeria. The study will adopt a quantitative quasi-experimental or analytical cross-sectional research design. The study population will comprise undergraduate and postgraduate public health students enrolled in selected universities and other accredited tertiary institutions offering public health programmes in Nigeria. A multistage sampling technique will be used to select geopolitical zones, states, institutions, public health departments, academic levels, and eligible students. Disability-inclusive health education will be assessed using indicators such as exposure to disability-inclusion training sessions, frequency and duration of education, knowledge of different types of disabilities, accessibility requirements, disability rights, inclusive health communication, respectful language, reasonable accommodation, accessible health facilities, inclusive health promotion, disability-sensitive data collection, referral services, assistive technologies, community participation, and strategies for reducing physical, communication, social, and institutional barriers. Disability-inclusive practice knowledge will be assessed using indicators such as ability to identify barriers to healthcare access among persons with disabilities, knowledge of accessible health communication methods, understanding of reasonable accommodation, knowledge of appropriate interaction with persons with disabilities, recognition of accessibility requirements in health facilities, understanding of inclusive health-promotion strategies, knowledge of disability-sensitive data collection, awareness of assistive technologies, knowledge of inclusive emergency preparedness, and ability to identify appropriate public health interventions for persons with disabilities. Data will be collected using structured questionnaires, disability-inclusive health knowledge assessment tools, case scenarios, practical accessibility assessment exercises, and pre-test and post-test assessments where a quasi-experimental intervention is adopted. Descriptive statistics will be used to summarize students' demographic and academic characteristics, previous exposure to disability-related education, experience with persons with disabilities, and baseline disability-inclusive practice knowledge. Inferential statistical techniques, including chi-square tests, paired and independent t-tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the effect of disability-inclusive health education on disability-inclusive practice knowledge. Where a quasi-experimental design is adopted, knowledge scores before and after the educational intervention may be compared with those of a comparison group to determine changes associated with the intervention. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that disability-inclusive health education has a significant positive effect on disability-inclusive practice knowledge among public health students in Nigeria. Students exposed to structured and practical disability-inclusive health education are expected to demonstrate greater knowledge of accessibility requirements, inclusive communication, reasonable accommodation, disability rights, and strategies for reducing barriers to healthcare than students without comparable exposure. Practical activities involving accessibility assessments, case scenarios, communication simulations, and interaction with disability organizations or persons with disabilities may further improve students' understanding and confidence in applying inclusive public health principles. However, limited practical exposure, inadequate teaching resources, insufficient accessibility in training institutions, limited specialist knowledge, and insufficient opportunities for interaction with persons with disabilities may reduce the effectiveness of education alone. The study therefore expects practical, participatory, accessible, and competency-based disability-inclusive health education to contribute significantly to improved disability-inclusive practice knowledge among public health students in Nigeria. The study is expected to contribute to the literature on disability-inclusive healthcare, public health education, health equity, accessibility, disability rights, inclusive health promotion, health communication, community health, and public health practice in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, Federal Ministry of Education, National Commission for Persons with Disabilities, universities, schools of public health, public health departments, healthcare organizations, disability organizations, professional and accreditation bodies, development partners, public health practitioners, and policymakers regarding strategies for strengthening disability-inclusive public health practice. The study will also provide evidence-based recommendations for integrating disability-inclusive health education into public health curricula, expanding practical accessibility training, strengthening disability-sensitive health communication, improving students' understanding of reasonable accommodation, increasing interaction with persons with disabilities, and developing competency-based programmes that prepare future public health professionals to design and implement equitable and disability-inclusive health services across Nigeria.

Keywords: Disability-inclusive health education, disability-inclusive practice knowledge, public health students, disability inclusion, health equity, accessibility, inclusive healthcare, disability rights, health promotion, public health education, Nigeria.