Access to reproductive health services: the case of women with physical disabilities in Nairobi
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Date
2008Author
Mukasa, Grace S W M
Type
ThesisLanguage
enMetadata
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This study was on 'Access to Reproductive Health Services for Women with Physical
Disabilities in Nairobi'. Its objectives were; to explore factors that prevent disabled women from
visiting reproductive health service providers; to establish the difficulties disabled women face
when they visit reproductive health service providers; to explore the challenges reproductive
health care providers face when serving disabled women; and to find out measures that can be
put in place to increase access to reproductive health care for disabled women.
The study found that among the difficulties that women with disabilities face when they visit
reproductive health service providers are mainly accessing the various physical facilities as they
are disability unfriendly. Some have steps/stairs and no ramps for those on wheel chairs and who
use crutches, Getting on to high exam beds with not steps or assistance was also a problem that
the women experienced at the service provider. Accessing public transport, which is the most
convenient means of travel to the health facility, was also a challenge. This is because of the way
the buses and matatus are built does not allow for easy boarding. The doors and the aisles are
narrow and wheel chairs cannot fit. The steps are also steep such that even those using crutches
and wearing caliphers have difficulties. In addition most public service providers/personnel are
always in a hurry and are in competition with others and therefore, do not have the patience to
wait or assist women with disabilities board the vehicles. The challenges experienced just trying
to get to a health provider discourages the women from g~g when they are unwell.
The study observed that most of these women had not progressed beyond primary school level
and were thus engaged in small petty businesses. As such, they were struggling to make a living
and the financial resources available were strained and this affected their ability to afford health
care. The study noted that a significant proportion of those who did not seek the information on
reproductive health did not think they needed to. This was either because they had stopped
having children, did not have any or were not sexually active, indicating a lack awareness as to
the scope of reproductive health issues and limiting them to child-bearing and contraceptives, yet
there are other concerns like breast and cervical cancer and management of infertility.
The survey also revealed that medical personnel have a bad attitude towards women with
disabilities. Some were said to use abusive language, ignore them, harass them when they cannot
move at the same speed or do things as other able bodied women. The women interviewed also
said that they received negative reactions when they sought information on sexuality and family
planning as the personnel wondered why they would want to engage in sex in their condition.
Thus, personal and shared unfavourable experiences at the hands of service providers and with
the facility may be factors that prevent disabled women from visiting reproductive health
providers.
On the service provider side, the challenges they face when serving women with physical
disabilities included positioning them for procedures and lack of appropriate equipment in the
facility suited to those with disabilities. Lack of awareness and information on reproductive
health among women with disabilities was also found to be a challenge by the service providers.
They also admitted as to there being no training that prepares them on how to deal with patients
with disabilities.
In light of the findings, the study recommends that since awareness seminars for those with
disabilities are an important source of reproductive health information these should be enhanced
to include topics covering more than STDs, contraceptives and HIV/AIDS. There is also need for
creating awareness among the medical personnel, to change their attitude towards sexuality and
disability as was indicated by the reactions the women-w.ith disabilities received on seeking information on sexuality and family planning. Given the challenges women with disabilities face
in accessing buildings and public transport the government should establish a responsible
authority to oversee the accessibility of the build-up environment by leveling of pavements,
building of ramps, installing lifts and ensuring access to other public places and utilities and the
building of accessible public vehicles. Formulation and implementation of the relevant policies
as per the Persons with Disabilities Act, 2004 to enhance the built environment to make it
disability friendly will ease access not only to health providers but also to other facilities and
amenities.
Publisher
Institute of Anthropology, Gender & African Studies, University of Nairobi
Description
Master of Arts in Gender and Development