Bridging the gap between persons with disabilities and sexual and reproductive health services

It is estimated that 12.4% of Uganda’s population is living with a disability. Persons with disabilities have the same sexual and reproductive health and rights (SRHR) needs as other people and experience the ramifications of SRHR issues more as they are exacerbated by disabilities yet they often face challenges in accessing requisite information and services. This has left many persons with disabilities especially the young girls and women vulnerable to issues like unplanned pregnancies and sexually transmitted diseases.

Persons with disabilities face persistent social disadvantages stemming from discrimination, stigma, and prejudice and the routine failure to incorporate disability into building policy and program designs, physical, socio-economic, socio-cultural, and legal barriers that continue to limit access to health care including sexual reproductive health and right information and services.

Health needs of the youth are de-prioritized, and they face additional barriers to care, particularly sexual and reproductive health care. These impacts are magnified for young people who are already marginalized and stigmatized in their access to SRHR information and services.

On 5th May 2020, we decided to take the conversation online with a tweet chat together with Reach A Hand,  our member under the Make 12.4% Work Initiative, to advocate for and be a voice for young persons with disabilities’ SRHR. This was also a way to gather various opinions and ideas from persons with disabilities themselves to shape and guide opinions for policymakers and stakeholders to act. 

One of the major reasons for lack of access to services is inaccessible buildings that limit movement for those using wheelchairs or crutches to service centers. These service points, before erecting buildings, need to hire accessibility experts to audit their buildings to ensure accessibility however this often goes unplanned for.

Another is the lack of inclusive programming in SRHR. Many community programs do not engage or leave out youth with disabilities in their programming. James Ocen, a Peer Educator with Reach A Hand and Vice President Youth Advisory Committee under the SRHR Alliance said, “There is a need for further investments in capacity building, training, creation of inclusive participation spaces for young PWDs. Through this, young people with disabilities would meaningfully engage in programming that benefits their SRHR needs” 

“Looking at health centers in the communities, youth-friendly services lack the components of being youth disability-friendly. Young persons with disabilities lack sign language interpreters, lack confidentiality plus trained healthcare providers to support them.” Said James Ocen. Service providers are not trained on how to handle PwDs and some have a negative attitude towards them. This has left PwDs especially the deaf in fear to go to these health facilities to access services.

Due to the current COVID-19 pandemic and lockdown, transport has been limited so people have resorted to walking to their desired destinations. This is a big challenge for persons with disabilities who cannot walk to health centers to receive services. However, SRH services have not been prioritized during the lockdown yet some of these young people are sexually active. One of the contributors to the tweet chat said, “In my community, young PWDs don’t know about their HIV status due to no service delivery in this lockdown.” @TimolightsUG. 

However, we need to have young people with disabilities at the forefront of their health needs. The question is what can they do to have their SRHR needs addressed?. Shamim Nampijja the Communication and Information Officer NUWODU advised that “Youth with disabilities should become self-advocates for enabling legal and policy environments where young people can access services with no barriers.”

There is a silence within society that pervades many areas of disability and sexuality resulting in the views of disabled people being rendered absent. It is possible to address some of these silences by doing more research on SRHR of persons with disabilities, CSOs which are SRHR based and DPOs working closely to ensure that PWDs are not left out in planning, programming, and implementation, and are included in the target groups.