A/HRC/44/41 for receiving food owing to stigma and discrimination, have their rations stolen or be separated from family or people who would otherwise provide assistance with eating and drinking.68 74. Equal access to health services is often not guaranteed. Data received from needs assessments of older persons in Africa and the Middle East suggest that older persons with disabilities do not access health care on an equal basis with the overall internally displaced population. 69 Lack of proximity and accessibility of health-care structures, lack of accommodation of their specific health-care needs and disruption of the supply of the medication and equipment they require are some of the additional challenges faced by persons with disabilities. Injuries, psychological distress, malnutrition and other conditions may particularly impact persons with existing disabilities, or for other persons result in impairments leading to long-term disability. Access to sexual and reproductive health care for persons with disabilities is generally a low priority for health-care providers, owing to misconceptions that persons with disabilities are not sexual beings. That becomes an even greater challenge in emergency and displacement situations. 75. Ensuring that persons with disabilities, family members and organizations actively participate in decision-making and in designing, implementing, monitoring and evaluating health programmes in displacement situations is fundamental to promoting inclusiveness and accessibility. Additional targeted action may be necessary to accommodate the individual requirements of persons with different types of disability to address specific barriers that may arise in the design and delivery of health services. Access to mental health care and psychosocial safety is paramount in displacement situations and should be available for all members of the community. 76. Service providers have shown positive and inventive efforts to ensure that persons with disabilities are not excluded from relief efforts, such as transportation and door-to-door services, fast-track systems and the creation of disability support networks. However, they often address only the situation of people with physical disabilities and are frequently not integrated into an overall strategy to ensure equal accessibility of aid and services. Deliberate action is needed from the outset of any assistance project to include people with disabilities in service provision and to conceptualize an appropriate universal design of buildings and facilities. International donors have a role to play in ensuring that aid is inclusive, including by funding proposals that show that all activities are safe and accessible, and that persons with disabilities are included in needs assessments, beneficiary selection, protection and assistance activities and monitoring and evaluation efforts.70 77. The participation of organizations of persons with disabilities in inclusive assessments, planning and budgeting, the design and implementation of assistance projects and the training of humanitarian staff in disability awareness and communications are crucial to overcoming the common challenges met by service providers. Efforts to improve inclusion, if integrated from the start, do not signify higher costs, but rather a different way of thinking and more attention paid to the issue. More systemic issues, such as the lack of visibility of persons with disabilities in assessment and response plans, owing to a lack of collection of disaggregated data, and the failure to report violations of the rights of persons with disabilities, need to be carefully addressed. 78. In the Inter-Agency Standing Committee guidelines a section is dedicated to bridging the gap between accessibility and reasonable accommodation, and in an annex there is a further explanation of the process for the provision of reasonable accommodation, given that this critical measure to ensure equal access is still not consistently understood and applied by humanitarian stakeholders. 68 69 70 16 See contributions from UNFPA and Light for the World. See contribution from HelpAge International. See contribution from the United States. See also European Commission, “The inclusion of persons with disabilities in EU-funded humanitarian aid operations” (January 2019).