Reproductive health challenges for women with physical disabilities in Mombasa County
This was an exploratory cross-sectional study of reproductive health challenges faced by women with physical disabilities in seeking reproductive health services in public health facilities in Mombasa County. The specific objectives of the study were to establish facts influencing reproductive health seeking practices determining accessibility challenges and identifying care provision problems faced by women with physical disabilities. Purposive sampling was used to select three organizations dealing with persons with disabilities from where 45 respondents to survey questionnaires were conveniently sampled. Four FGDs were conducted, two of which were with older women and the remainder with younger women. The participants in these FGDs were purposively selected. Case narratives were carried out with six women purposively chosen to give insights in their lived accounts in seeking reproductive healthcare. Moreover, the study sought the experts' opinion from twelve key informants consisting of ten health workers (doctors and nurses) and two NGO officers working for disability organization. The findings indicate that women with physical disabilities face several challenges while seeking reproductive healthcare. Some of the challenges include communication difficulties, bad experiences with healthcare providers, the physical access and mobility challenges due to built environment and the attitudes of healthcare providers which hinder many women with physical disabilities from inquiring more on contraceptive use and sexuality experiences. The challenges presented a range of barriers to seeking and receiving satisfactory reproductive health care services. The barriers can be divided into two major categories: structural barriers related to access or physical accommodation and the socio-cultural concerning relationships with health care providers. The above barriers affect the quality of the reproductive healthcare and present major areas of concern if this group of women is to be adequately served. This study recommends that government institutionalize and provide disability programmes and support services in the healthcare system. Equipments should be disability friendly in the health facilities to provide comfort to WWD. Proper sensitization and availing of adequate health information on contraception and STls is urgent to this population group. Furthermore, women with disabilities should be provided with adequate information on pregnancies, birth control and other sexuality education that recognizes them as human beings with needs. The government should strengthen, facilitate and work hand in hand with disabled people's organizations and adapt educational materials that are suitable for them. Finally, interventions should be directed at enhancing providers' understanding of how to work effectively with women who have physical disabilities. The training on how to treat disabled people be included in medical school's curriculum and in hospitals for those already practicing and the medics be sensitized on language that is not offensive when handling disabled people.