Achieving universal reproductive health coverage for deaf women in Ghana: an explanatory study of knowledge of contraceptive methods, pregnancy and safe abortion practices

Abstract

Background The first world conference on sexual and reproductive health (SRH) in 1994 helped create the awareness that reproductive health is a human right. Over the years, attempts have been made to extend services to all persons; however, lapses persist in service provision for all in need. Recently, countries have been encouraged to target minority groups in their reproductive health service provision. However, studies have rarely attempted to develop deeper insights into the experiences of deaf men and women regarding their knowledge of SRH. The purpose of this study was to develop an in-depth understanding of the knowledge of deaf persons regarding services such as knowledge of contraceptive methods, pregnancy and safe abortion practices. Methods A sequential explanatory mixed-methods approach was adopted for this study. In the first quantitative phase, 288 deaf persons recruited from three out of the 16 regions in Ghana participated in this study. They completed a 31-item questionnaire on the main issues (knowledge of contraceptive methods, pregnancy and safe abortion practices) addressed in this study. In the second phase, a semi-structured interview guide was used to collect data from 60 participants who took part in the first phase. The key trend emerging in the first phase underpinned the interview guide used for the data collection. While the quantitative data were subjected to the computation of means, t-tests, analyses of variance, correlations and linear regressions to understand the predictors, the in-depth interviews were analysed using the thematic method of analysis. Results The results showed a convergence between the quantitative and qualitative data. For instance, the interview material supported the initial findings that deaf women had little knowledge of contraceptive methods. The participants offered reasons explaining their inability to access services and the role of religion in their understanding of SRH. Conclusion The study concludes by calling on policymakers to consider the needs of deaf persons in future SRH policies. The study limitations and other implications for future policymaking are discussed.

A mixed-methods study of the awareness and functionality of sexual and reproductive health services among persons with disability in Ghana

“…These misconceptions were influenced by religious beliefs and doctrines that opposed the use of contraceptives. The influence of religion on SRH and health seeking behavior of PwDs has also been reported in previous studies in Ghana [ 9 , 32 ]. Some of the participants believed that family planning services should only be accessed by married people or those with children, and that using family planning products could contribute to dizziness, infertility, fibroid and obesity.…”

“…Sexual health refers to the prevention and treatment of STIs and other sexual problems [ 7 ], while sexual rights include the right to sexual education, the freedom to choose a partner, the right to consensual sex, and freedom from sexual abuse [ 8 ]. Reproductive health involves the ability and capacity to learn about the reproductive system, contraception, and safe abortion services [ 9 , 10 ], while reproductive rights entail the recognition and respect of individuals’ autonomy and decision-making regarding their reproductive lives [ 11 ].…”

“…In Ghana, a study by Obasi et al[ 23 ] reported 67.1% of knowledge on SRH. Some of the factors associated with SRH awareness and knowledge among PwDs are age, sex, marital status, employment status, religion, and sources of information [ 9 , 17 , 19 , 20 , 23 – 25 ].…”

“…These include the National Health Insurance Scheme [ 26 ], the National Health Policy [ 27 ], the Disability Act 715 [ 28 ], the Adolescent Health Service Policy and Strategy [ 29 ] and the Free Maternal Healthcare Policies [ 30 , 31 ]. However, there is limited evidence on how these policies and interventions have affected the awareness and functionality of the SRH services for PwDs [ 9 , 25 , 32 ]. Moreover, there is a dearth of studies on the level and determinants of SRH knowledge and awareness among PwDs in Ghana.…”

“…Moreover, there is a dearth of studies on the level and determinants of SRH knowledge and awareness among PwDs in Ghana. Most of the existing studies have either focused on a narrow aspect of SRH such as abortion [ 32 ] or contraceptive methods [ 9 ] or targeted specific groups of PwDs, such as those with physical disabilities [ 33 ] or visual impairments [ 34 ]. To address this gap, this study employs a mixed-methods approach to assess the awareness and knowledge of SRH services among PwDs (visually impaired and physically disabled) and their perceptions on the functionality of SRH services and interventions in the Ashanti region of Ghana.…”