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From words to actions: systematic review of interventions to promote sexual and reproductive health of persons with disabilities in low- and middle-income countries

HAMEED, Shaffa
MADDAMS, Alexander
LOWE, Hattie
DAVIES, Lowri
KHOSLA, Rajat
SHAKESPEARE, Tom
2020

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Persons with disabilities have the same sexual and reproductive health and rights (SRHR) as non-disabled persons. Yet they face numerous barriers in their access to sexual and reproductive health services and their rights are often not met. Evidence on SRHR for persons with disabilities is sparse, particularly evaluations of interventions demonstrating ‘what works.’ This systematic review assessed interventions to promote SRHR for persons with disabilities in low- and middle-income countries.

The method involved searching for qualitative, quantitative or mixed method observational studies representing primary research, published between 2010 and 2019, using MEDLINE, Embase, PubMed, Global Health and CINAHL Plus

 

BMJ Global Health 2020;5:e002903.

http://dx.doi.org/10.1136/bmjgh-2020-002903

Seeing the invisible: Sexuality-related knowledge, attitudes and behavior of children and youth with disabilities in China

SHANGHAI INSITITUTE OF PLANNED PARENTHOOD RESEARCH (SIPPR)
UNESCO
HUMANITY & INCLUSION (HI)
2019

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Young people with disabilities have the same right to Sexual and Reproductive Health (SRH) as their peers without disabilities, but their needs and rights are often overlooked. This study examines the SRH status of young people with disabilities in China. In particular, the study explored the sexuality-related knowledge, attitudes and behaviour of young people with disabilities as well as their access to sexuality-related information, education and services. The findings of the study are intended to provide evidence to support decision-making by government agencies, educators, development workers and other relevant stakeholders regarding developing and implementing disability-inclusive SRH and sexuality education policies and programmes for young people in China.

The study, using quantitative and qualitative methods, was conducted in 2015 among unmarried young persons aged 12 to 24 living with visual, hearing, physical and intellectual disabilities, in both urban and rural areas. The analysis was based on data collected through 707 completed valid questionnaires, 20 group interviews and 35 individual interviews with young people with disabilities, and individual interviews with 60 parents and teachers, along with one case study.

HIV & disability in West Africa: A combined analysis of 4 studies conducted in Burkina Faso, Niger, Guinea Bissau and Cape Verde (2019) - VIH & Handicap en Afrique de l’Ouest : Une analyse combinée de 4 études conduites au Burkina Faso, Niger, Guinée Bis

DE BEAUDRAP, Pierre
2019

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This paper includes four studies which seek to better understand the situation by HIV-related situation of disabled men and women living in West Africa. 
Using epidemiological investigation, qualitative interviews and collections of testimonies, these studies offer insight into the vulnerability of people with disabilities in the area of ​​sexual health
 

Family planning for women and girls with disabilities

FRASER, Erika
CORBY, Nick
January 2019

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Individual, environmental, attitudinal and institutional factors affecting access to and uptake of family planning for women and girls with disabilities in low and middle income countries are explored through a rapid literature review. Evidence of good practice concerning increasing full free and informed contraceptive choice is also examined.

 

Disability Inclusion Helpdesk Report. Pilot 2

Everybody Matters: Good practices for inclusion of people with disabilities in sexual and reproductive health and rights programmes

Van SLOBBE, Caroline
November 2017

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This publication provides introductory chapters from two activists who work to create better opportunities for people with disabilities in Nigeria and India. Subsequently, the challenges that organisations worldwide have encountered whilst improving the access to and knowledge of sexual and reproductive health and rights for people with disabilities are presented. Ways in which they managed to find solutions and the results achieved are reviewed. Some cases show the importance of a more personal approach whilst others emphasise the advantage of changing systems and policies. Different regions, types of disabilities and various SRHR-topics are reflected in these stories. All cases provide lessons learnt that contribute to a set of recommendations for improved responses. The closing chapter highlights the challenges, solutions, and ambitions that are presented and lead up to a concise overview of recommendations.  

Good practice examples include:

A shift in SRH programming (Nepal)

Breaking Barriers with performance art (Kenya)

Her Body, Her Rights (Ethiopia)

People with disabilities leading the way (Israel Family Planning Association)

Best Wishes for safe motherhood (Nepal)

It’s my body! (Bangladesh)

Calling a spade a spade (Netherlands)

Four joining forces (Colombia)

Change agents with a disability (Zimbabwe)

Tito’s privacy and rights (Argentina)

Sign language for service providers (Kenya)

The grace of motherhood: disabled women contending with societal denial of intimacy, pregnancy, and motherhood in Ethiopia

TEFERA, Balaynesh
et al
September 2017

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Ethiopian disabled women’s experiences of intimacy, pregnancy and motherhood are reported. Qualitative, in-depth, and semi-structured interviews along with personal observations were used to explore the full experiences of participants. Interview data revealed that mothers experienced significant challenges with regard to accessibility of health centers, physician’s lack of knowledge about and problematic attitudes toward them and more general societal prejudices towards individuals with disability. The 13 participants were employed women with physical or visual disabilities, and the interviewees were from the Addis Ababa metropolitan area, Ethiopia.

 

Disability & Society, 32:10, 1510-1533

DOI: 10.1080/09687599.2017.1361385

No justice : torture, trafficking and segregation in Mexico

RODRIGUEZ, Priscila
ROSENTHAL, Eric
GUERRERO, Humberto
July 2015

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This report presents the findings of Disability Rights International (DRI)'s two-year investigation into the treatment of children and adults with mental disabilities in Mexico City which found a pattern of egregious and widespread human rights violations. The investigation found that in Mexico City having a disability can mean a life of detention and uncovered the existence of a “blacklist” of particularly abusive institutions that the Mexico City authorities are aware of – yet they permit these facilities to operate. DRI visited five of 25 facilities on the blacklist and specifically highlight the findings from Mama Rosa and Casa Esperanza, which was so abusive that DRI filed a formal complaint to DIF and sought immediate action by DIF to protect detainees. The report outlines the overall findings and how Mexico can take steps toward reform and justice calling for immediate steps to enforce the basic human rights of people with disabilities and outlines

Note: the report is available in pdf and word versions in both English and Spanish

Abuse and denial of sexual and reproductive rights of women with psychosocial disabilities in Mexico

RODRIGUEZ, Priscila
et al
February 2015

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This report presents the situation faced by women with psycho-social conditions in Mexico based on the results of a year-long study. This research included the application of a questionnaire to fifty-one women with psychosocial disabilities who were either members of the Colectivo Chuhcan or received outpatient services at four different health clinics and psychiatric institutions in Mexico City. The main finding of this report is that the Mexican government has failed to implement policies that ensure that women with psychosocial disabilities have safe access to sexual and reproductive health services, on an equal basis with others. It is recommended this research be extended to the rest of the country to gain a clearer picture on the situation of the sexual and reproductive rights of women with disabilities at a national level

Human Rights

www.macao-tz.org
December 2014

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Malezi AIDS Care Awareness Organization (MACAO) is a non-profit organization reaching out to neglected Indigenous people in Ngorongoro District, Arusha Region of Northern Tanzania.  Macao founded in 2003, Macao is a humanitarian organization that provides assistance to approximately 200,000 Indigenous Maasai community in Ngorongoro district for addressing needs of water and sanitation, food security, health Care Research, Education, Research environment, Maasai Traditional Research, Human Rights and sustainable economic development by strengthening their livelihoods.  In addition to responding to major relief situations, MACAO focuses on long-term community development through over 4 Area Development Project. We welcome the donors and volunteers to join us in this programs, we are wolking in ruro villages.

Moving forward and gaining ground: the sterilisation of women and girls with disabilities in Australia

FROHMADER, Carolyn
June 2012

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This paper addresses the issue of forced sterilisation and reproductive right of women and girls with disability in Australia. "It discusses some of the critical issues in the consideration of forced sterilisation as a human rights issue, and looks at some of the key strategies WWDA has employed to advance our efforts to promote the sexual and reproductive rights of disabled women and girls, on an equal basis with other women and girls"
Available in pdf, word, large print text only and powerpoint presentation formats

Sterilization of women and girls with disabilities : a briefing paper

WOMEN WITH DISABILITIES AUSTRALIA (WWDA)
et al
November 2011

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The paper gives a background to the issue of forced sterilisation, outlines various international human rights standards that prohibit forced sterilisation, and offers several recommendations for improving laws, policies, and professional guidelines governing sterilisation practices. It is useful for anyone interested in the sterilization of women and girls with disabilities

Access to health care, reproductive health and disability: A large scale survey in Sierra Leone

GROCE, Nora
TRANI, Jean-Francois
BROWN, Joyce Brown
KETT, Maria
BAH, Osman
MORLAI, Teddy
BAILEY, Nicki
2011

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This is the first study to compare health status and access to health care services between disabled and non-disabled men and women in urban and peri-urban areas of Sierra Leone. It pays particular attention to access to reproductive health care services and maternal health care for disabled women. A cross-sectional study was conducted in 2009 in 5 districts of Sierra Leone, randomly selecting 17 clusters for a total sample of 425 households. All adults who were identified as being disabled, as well as a control group of randomly selected non-disabled adults, were interviewed about health and reproductive health. As expected, we showed that people with severe disabilities had less access to public health care services than non-disabled people after adjustment for other socioeconomic characteristics (bivariate modelling). However, there were no significant differences in reporting use of contraception between disabled and non-disabled people; contrary to expectations, women with disabilities were as likely to report access to maternal health care services as did non-disabled women. Rather than disability, it is socioeconomic inequality that governs access to such services. We also found that disabled women were as likely as non-disabled women to report having children and to desiring another child: they are not only sexually active, but also need access to reproductive health services.

Preventing HIV/AIDS among persons with disabilities : a handbook for policy makers, healthcare providers and care givers of people with disabilities

IVOM, Damian O
2009

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This handbook highlights the factors responsible for the spread of HIV, methods of preventing it within persons with disabilities and how they can be reached and integrated into HIV and AIDS programmes and activities, so as to cause a reduction within its communities and in the general population. It is premised on the fact that many programmes and activities on HIV and AIDS in developing countries especially Sub-Saharan Africa have not realised the need to include persons with disabilities

PleasureABLE : sexual device manual for persons with disabilities

NAPHTALI, Kate
MACHATTIE, Edith
2009

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"This manual was created as a practical resource for persons with disabilities and health care clinicians who work with these clients. It includes research, clinical expertise, and product information to aid with dialogue surrounding sexual and reproductive issues and disabilities. The information presented here is not prescriptive, and the specific products not recommended per se, but are meant to provide examples and illustrations of some of the potential options that can be introduced into the sexual practices of the individual or be used as an adjunct in the discussions of sexuality and disability by the health care clinician. The devices included are a sampling of what is available (in Canada) in 2009"

Sex and relationships for people with learning disabilities : a challenge for parents and professionals

GARBUTT, Ruth
2008

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"This paper considers some of the issues around sex and relationships for people with learning disabilities. It is essentially a discussion paper, highlighting previous research, and information about the rights of people with learning disabilities to have sex and relationships. It particularly focuses on concerns for parents and some implications for professional practice that have arisen from a research project that is trying to find out more about the issues. The main messages coming from parents within the research project is that there is a need for clear, concise information about sex and relationships for young people with learning disabilities and there is also a need for professionals to give parents more support"
Mental Health and Learning Disabilities Research and Practice Journal, 5

The sexual heath needs of young people with learning disabilities

FRASER, Shirley
SIM, Judith
2007

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This briefing paper summarises the key findings from an evidence review on the sexual health and wellbeing of young people with learning disabilities. The review assimilates various forms of evidence, including the voices of young people themselves and emerging findings from practice. It also identifies a number of potential future actions that will help ensure that sexual health services and sex and relationships education are better able to meet the needs of young people with learning disabilities, as well as those of their parents and the professionals that support them

Effective HIV/AIDS and reproductive health information to people with disabilities

MUNTHALI, Alister
MVULA, Peter
ALI, Sandra
October 2004

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This study explores the sexual and reproductive health needs and experiences of people with disabilities, as well as perceptions about HIV and AIDS and disability. The purpose is to address the accessibility of health communication for people with different impairments. This study would be useful for anyone with an interest in HIV and AIDS and disability

Discrimination against women with disabilities

BELEZA, Maria Leonor
October 2003

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This publication highlights the difficulties that women with disabilities often encounter and includes practical information on how to improve their situation. The report analyses the underlying factors of double discrimination based on gender and disability and proposes concrete actions to achieve equality. This report would be of interest to all those concerned with the fight against discrimination throughout Europe

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