India's Accessibility Paradox: Compliant Metros and Airports, but Inaccessible Hospitals and Clinics

India's Accessibility Paradox: Compliant Metros and Airports, but Inaccessible Hospitals

India's healthcare infrastructure significantly lags in implementing disability-friendly architecture, despite robust compliance in public facilities like metros, airports, and Special Economic Zones (SEZs). While laws such as the Rights of Persons with Disabilities (RPwD) Act, 2016, mandate universal accessibility, enforcement gaps in hospitals leave millions with disabilities facing barriers to care.​

This disparity highlights a systemic failure in prioritizing inclusive design for healthcare, where retrofitting older facilities remains minimal compared to new public infrastructure projects.​

Legal Framework for Accessibility

The RPwD Act, 2016, and its 2017 Rules require barrier-free access in all public and private buildings, including healthcare institutions, with specific standards for ramps, lifts, and accessible medical equipment.​

In 2023, the Ministry of Health and Family Welfare notified Accessibility Standards for Healthcare, covering arrival zones, outpatient departments, wards, and equipment like adjustable examination tables and wheelchair-compatible toilets.​

The Harmonised Guidelines and Standards for Universal Accessibility in India 2021 further emphasize compliance for diverse disabilities, including physical, visual, and cognitive impairments, applicable to hospitals nationwide.​

Despite these, audits reveal widespread non-compliance in healthcare, with only partial adherence in areas like reception counters and washrooms.​

Compliance in Metros, Airports, and SEZs

Indian metro systems, such as Delhi Metro, feature comprehensive accessibility, including tactile flooring, level boarding platforms, reserved seats, and audio announcements, making them navigable for wheelchair users and visually impaired individuals.​

All 35 international and 55 domestic airports provide ramps, lifts, ambulifts for boarding, and dedicated assistance, with Bengaluru's Kempegowda International Airport earning ACI Level 2 accreditation for its inclusive measures.​

SEZs, governed by similar public building norms under the Accessible India Campaign, incorporate barrier-free designs in new constructions, such as wide corridors and signage, to attract global investment while meeting RPwD standards.​

Over 3,120 bus stations and 42,000 partially accessible buses complement this, showing proactive retrofitting in transport infrastructure funded by central schemes.​

Shortcomings in Healthcare Facilities

Audits in major hospitals show only 36% full compliance with Central Public Works Department checklists, with deficiencies in accessible toilets (66.7% lacking), emergency evacuation plans, and staff training.​

Private and public hospitals often overlook standards for examination rooms, laboratories, and medical equipment, like non-adjustable radiological devices, exacerbating barriers for persons with locomotor disabilities.​

A 2022 study in a national institution found 51 pointers non-applicable or partially met, including slip-resistant floors and lowered counters, leading to higher risks for differently-abled patients.​

Rural and urban disparities amplify this, with 42% of public health centers scoring below 50% on infrastructure benchmarks, including accessibility features.​

Reasons for the Disparity

Healthcare lags due to fragmented public-private systems, where private hospitals prioritize curative care over inclusive design, and public ones face budget constraints for retrofitting legacy buildings.​

Unlike metros and airports, which receive dedicated funding under schemes like Accessible India Campaign (retrofitting 1,314 state buildings), hospitals lack similar enforcement, with only 20% of facilities meeting IPHS standards.​

Construction focus in healthcare remains hospital-centric, ignoring primary care accessibility, while cultural and regulatory silos hinder audits and penalties for non-compliance.​

New infrastructure in SEZs and transport benefits from international benchmarks and central oversight, but healthcare's diverse providers (from clinics to super-specialty hospitals) evade uniform implementation.​

Implications and Path Forward:

Inaccessible hospitals violate the right to health for India's 2.68 crore persons with disabilities, increasing unmet needs and healthcare inequities.​

To bridge the gap, mandatory access audits, incentives for NABH-accredited inclusive designs, and integration with NHM funding could mirror transport successes.​

At UDstudio, designs are 100% disability-friendly as a baseline principle upheld without compromise, part of our pursuit for perfection informed by Ar. Bhavin Kothari's international expertise.