Sexual and reproductive health services for women with disability: a qualitative study with service providers in the Philippines

Abstract

BackgroundThe Philippines has ratified the United Nations Convention on the Rights of Persons with Disabilities and recently passed domestic legislation protecting the sexual and reproductive rights of people with disability. However women in the Philippines continue to report barriers to sexual and reproductive health services, and there is limited empirical evidence available to inform policy makers’ efforts to respond. This study aims to contribute to the available evidence by examining service providers’ perceptions of disability and their experiences providing sexual and reproductive health services to women with disability.MethodsThe study was conducted as part of a larger three-year program of participatory action research that aims to improve the sexual and reproductive health of women with disabilities in the Philippines. Fourteen in-depth interviews and two focus group discussions were conducted with a total of thirty-two sexual and reproductive health service providers in Quezon City and Ligao. Qualitative data were analysed to identify key themes in participants’ discussion of service provision to women with disability.ResultsAnalysis of service providers’ accounts suggests a range of factors undermine provision of high quality sexual and reproductive health services to women with disability. Service providers often have limited awareness of the sexual and reproductive health needs of women with disability and inadequate understanding of their rights. Service providers have had very little training in relation to disability, and limited access to the resources that would enable them to provide a disability inclusive service. Some service providers hold prejudiced attitudes towards women with disability seeking sexual and reproductive health services, resulting in disability-based discrimination. Service providers are also often unaware of specific factors undermining the health of women with disability, such as violence and abuse.ConclusionRecent legislative change in the Philippines opens a window of opportunity to strengthen sexual and reproductive health service provision across the country. However the development of services that are disability-inclusive will require substantial efforts to address supply-side barriers such as prejudiced service provider attitudes and limited capacity. Disability inclusion must be prioritised for the national goal of responsible parenthood and reproductive health to be realised for all.

Study of gynecological health of women with disabilities

“…Due to lack of interpreters, family members were the source of information and thus the women with disabilities remained on side track during assessment and management. 4 Participants of present study reported important role of family member as interpreter between the healthcare provider and the patient. It was noted that family members, especially husband and mother in law helped in postnatal care.…”

Attitudes Towards Sexuality in Males and Females with Intellectual Disabilities: Indonesia Setting

“…limited access to health information, limited access to sex education programs, knowledge and education, cultural norms, religious beliefs, and familiarity [17][18][19][20][21]. In addition, sexual and reproductive health services toward individual with ID facing with the spectrum of discrimination and exclusion in low and middle-income countries besides their vulnerabilities [9,22].…”

Disabled persons in Ghanaian health strategies: reflections on the 2016 adolescent reproductive health policy

“…The WHO Factsheet on Health and Disability 17 reports that the health needs of persons with disabilities are largely unmet and argues that more persons with disabilities look for health care than those without disabilities. A study in the Philippines 19 reported that girls and women with disabilities seeking SRH services face discrimination and negative attitudes at the hands of some health workers. An exposition on the SRH experiences of visually impaired women in Ghana 20 reveals how pregnant women and girls with disabilities were faulted and perceived as undeserving of motherhood, irrespective of whether they were married, or had experienced unwanted pregnancies.…”