Disability and Access to Sexual and Reproductive Health Services in Cameroon: A Mediation Analysis of the Role of Socioeconomic Factors

Abstract

There is growing evidence showing that people with disabilities face more frequently socioeconomic inequities than their non-disabled peers. This study aims to examine to what extent socioeconomic consequences of disability contribute to poorer access to sexual and reproductive health (SRH) services for Cameroonian with disabilities and how these outcomes vary with disabilities characteristics and gender. It uses data from a population-based survey conducted in 2015 in Yaounde, Cameroon. Mediation analysis was performed to determine how much of the total association between disability and the use, satisfaction and difficulties to access SRH services was mediated by education level, material wellbeing lifetime work participation and availability of social support. Overall, disability was associated with deprivation for all socioeconomic factors assessed though significant variation with the nature and severity of the functional limitations was observed. Lower education level and restricted lifetime work mediated a large part of the association between disability and lower use of HIV testing and of family planning. By contrast, while people with disabilities reported more difficulties to use a SRH service, no mediating was identified. In conclusion, Cameroonians with disabilities since childhood have restricted access to SRH services resulting from socioeconomic factors occurring early during the life-course.

Determinants of knowledge, attitudes, and practices in relation to HIV/AIDS and other STIs among people with disabilities in North-Shewa zone, Ethiopia

“…Concerning the practice of HIV testing, only 23.2% of participants have ever been tested for HIV infections. In line with our finding, PWDs were less likely to be tested for HIV in Cameroon [ 3 ] and Uganda [ 24 ]. Similarly, as reported by previous research, families of PWDs may not encourage them to get HIV services [ 17 , 23 , 25 ].…”

“…In Ethiopia, more than 15 million PWDs live with physical, sensory (hearing and visual loss), intellectual disabilities, or a combination of these disabilities [ 2 ]. The incidence of disabilities has been increasing due to accidents and the increase in chronic health conditions including HIV [ 3 , 4 ].…”

“…Persistent discrimination against and exclusion of PWDs increase their vulnerability of HIV infections [ 7 ]. Furthermore, there is a misconception that PWDs are sexually inactive and they are frequently overlooked in HIV prevention and AIDS (acquired immune deficiency syndrome) programs [ 3 , 5 ]. They are highly vulnerable to sexual abuse and experience social marginalization, which places PWDs at increased risk of HIV and STI infection [ 7 , 8 ].…”

“…Although people with disabilities require the same HIV/AIDS information, services and supports as all other members of society, they are excluded and neglected in all of the sectors responding to HIV and STI infections [ 3 ]. Remarkably, they are notably absent from equitable access and are often treated as a low priority for those services [ 8 , 9 ].…”

Barriers facing persons with disability in accessing sexual and reproductive health services in sub-Saharan Africa: A systematic review

“…Table 1 presents the characteristics of the eligible studies. Of the 26 eligible studies, 19 were qualitative in design [7,10,11,[18][19][20][31][32][33][34][35][36][37][38][39][40][41][42][43]; four used a survey design [44][45][46][47]; and three used mixed methods design [48][49][50]. The 26 studies were reported from twelve African countries: Uganda (seven studies) [7,10,31,32,34,37,39];…”