Challenges Women with Disability Face in Accessing and Using Maternal Healthcare Services in Ghana: A Qualitative Study

Abstract

BackgroundWhile a number of studies have examined the factors affecting accessibility to and utilisation of healthcare services by persons with disability in general, there is little evidence about disabled women's access to maternal health services in low-income countries and few studies consult disabled women themselves to understand their experience of care and the challenges they face in accessing skilled maternal health services. The objective of this paper is to explore the challenges women with disabilities encounter in accessing and using institutional maternal healthcare services in Ghana.Methods and FindingsA qualitative study was conducted in 27 rural and urban communities in the Bosomtwe and Central Gonja districts of Ghana with a total of 72 purposively sampled women with different physical, visual, and hearing impairments who were either lactating or pregnant at the time of this research. Semi-structured in-depth interviews were used to gather data. Attride-Stirling’s thematic network framework was used to analyse the data. Findings suggest that although women with disability do want to receive institutional maternal healthcare, their disability often made it difficult for such women to travel to access skilled care, as well as gain access to unfriendly physical health infrastructure. Other related access challenges include: healthcare providers’ insensitivity and lack of knowledge about the maternity care needs of women with disability, negative attitudes of service providers, the perception from able-bodied persons that women with disability should be asexual, and health information that lacks specificity in terms of addressing the special maternity care needs of women with disability.ConclusionsMaternal healthcare services that are designed to address the needs of able-bodied women might lack the flexibility and responsiveness to meet the special maternity care needs of women with disability. More disability-related cultural competence and patient-centred training for healthcare providers as well as the provision of disability-friendly transport and healthcare facilities and services are needed.

In search of universal health coverage – highlighting the accessibility of health care to students with disabilities in Ghana: a qualitative study

“…The limited or lack of support services presents a substantial barrier to students with disabilities when accessing health care. Consistent with previous studies, the available health care have limited provisions to support people with disabilities (15,18,39). This challenge is ascribed to limited prioritization of disability issues as well as weak monitoring and enforcement of regulations and laws (15,18,39).…”

“…Consistent with previous studies, the available health care have limited provisions to support people with disabilities (15,18,39). This challenge is ascribed to limited prioritization of disability issues as well as weak monitoring and enforcement of regulations and laws (15,18,39). For instance, the Ghana disability law (Acts 715, 2006) promote access to quality health care, including adequate medical rehabilitation.…”

“…The studies have documented the barriers and enablers informing access to health services for people with disabilities. However, the studies focus on the Sexual and Reproductive Health (SRH) needs of women with disabilities (22,39,40) and deaf patients (15)(16)(17)(18)(19). In addition, the evidence focused largely on the general disability population, with relatively no study targeting students.…”

“They must understand we are people”: Pregnancy and maternity service use among signing Deaf women in Cape Town

“…Despite widespread ratification of UNCRPD (4) and ICESCR (5), women with disabilities in Sub-Saharan Africa still face numerous barriers to receiving adequate sexual and reproductive health care (6, 7). Common themes reported in qualitative studies with people with disabilities include: expensive and limited transportation to facilities, physical inaccessibility of facilities, communication problems with health staff, and staff inexperience and insensitivity with people with disabilities (6, 7).…”

“…Common themes reported in qualitative studies with people with disabilities include: expensive and limited transportation to facilities, physical inaccessibility of facilities, communication problems with health staff, and staff inexperience and insensitivity with people with disabilities (6, 7). Even in South Africa, where the constitution specifically protects the rights of people with disabilities and cites access to reproductive rights in the right to access health care, this population still reports numerous difficulties (8, 9).…”