A qualitative study to explore the barriers and enablers for young people with disabilities to access sexual and reproductive health services in Senegal

Eva Burke,Fatou Kébé,Ilse Flink,Miranda Van Reeuwijk,Alex Le May

doi:10.1080/09688080.2017.1329607

Abstract

Use of sexual and reproductive health (SRH) services is low amongst young people in Senegal. Although the evidence base on young people’s SRH needs is growing, research on access to SRH services amongst young people with disabilities is negligible. Our study explored the SRH vulnerabilities and expressed needs for young people with disabilities, experiences of accessing SRH services and what access challenges they face. Male and female peer researchers conducted 17 focus group discussions and 50 interviews with young women and men with disabilities between 18 and 24 years with a physical, visual or hearing impairment in Dakar, Thies and Kaolack in Senegal. Young people with disabilities reported very low knowledge about, and use of, SRH services including contraception and gynaecological consultations, but demonstrated a need for them, and were reliant on others to accompany them to service providers, impeding their access to confidential services. Multiple cases of rape were revealed, particularly amongst women with hearing impairments. Key barriers to SRH services were financial barriers, provider attitudes and accessibility (related to their disability). SRH policies and interventions for young people with disabilities should be based on an understanding of the intersection of youth, disability and gender. Urgent and targeted action is needed to improve provider attitudes and capacity to respond to the needs of young people with disabilities and to address the burden of sexual violence.

Highlights

The exact proportion of the population living with disabilities in Senegal remains unknown; the World Health Survey in 2002–2004 reported it to be 15.5%1 but the more recent 2013 national census data estimates that 5.9% of the population in Senegal is living with a disability, approximately 800,000 people.[2]
We adopted a qualitative peer-to-peer approach to explore the sensitive nature of the research topic, with focus group discussions (FGDs) conducted first to gather information on overarching themes and general experiences young people with disabilities had in relation to sexuality, sexual and reproductive health (SRH) and access to services and products
This study highlights that young people with disabilities need access to SRH information and services but today face challenges in accessing them

Summary

Introduction

The exact proportion of the population living with disabilities in Senegal remains unknown; the World Health Survey in 2002–2004 reported it to be 15.5%1 but the more recent 2013 national census data estimates that 5.9% of the population in Senegal is living with a disability, approximately 800,000 people.[2]. Despite efforts to improve rights to education, health, employment and public services, people with disabilities in Senegal continue to face disproportionate disadvantages compared to the rest of the population: three out of four people with disabilities cannot read or write, health facilities and public buildings cannot physically accommodate them, and only 21% of those of working age have access to employment.[4]. The approach helps us to explore the convergence of different social identifiers, types of exclusion and marginalisation within a population or an individual.[5] Originally coined. Org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited

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Conclusion