Assessing Attitudes, Feelings and Opinions of Women Living With Disability on Their Reproductive Health in Kakamega County, Kenya

Abstract

Disability is defined as “an umbrella term, covering impairments, activity limitations, and participation restrictions [1]. One billion people, or 15% of the world’s population, have some form of disability, and the prevalence is higher in developing countries. This adds up to between 110 million and 190 million people. Eighty percent of persons living with disabilities live in developing countries, according to the UN Development Program [1]. Objective: This study set out to assess attitudes, feelings and opinions of disabled women on their reproductive health in Kakamega County, Kenya. Design: cross sectional survey study with both quantitative and qualitative approach in 2018 and 2019. Setting: 12 Sub Counties in Kakamega County. Sample: snow balling sampling technique. (n = 117) Analysis: Data was analyzed by use of descriptive statistics, descriptive narratives, chi squares and content analysis method of the main four themes namely pregnancy state, pregnancy care, society support and government support. Results: WLWD (women living with disability) had distorted marriages, more children, dependents, and less ANC attendance unlike the able bodied women. Conversely, able-bodied women were more likely to have their pregnancy planned compared to WLWD (OR: 1.8; 95%CI: 0.6 – 2.2; p=0.008) and some didn’t consent for the pregnancy I was raped”. Able bodied women were 60% more likely to perceive distance to facility≤ 1 hour compared to the WLWD (OR: 1.6; 95% CI: 1.4- 3.5; p=0.01) and were two times more likely to agree with that facility had provisions unlike WLWD. Pregnant WLWD had more health problems, 16.5% (17) babies of WLWD who were from un-partnered areas died and some babies were not immunized postnatally 2.9% (3). Some of the nice moments included love in the family increased, assistance in house chores and happiness of motherhood. Some of the hard moments included pregnancy related sickness, lack of finances, stigmatization from family members, difficulty in accessing healthcare and being abandoned by spouse during pregnancy period. Importance of ANC attendance included knowing their status, baby position and to avoid infection. All of them planned to deliver in a government hospital because they say it is affordable. Society doesn’t assist them much and majority received assistance from people other than their spouses. They believe to be neglected because of their disability status. “The community does not support us because they don’t expect us to get pregnant” Conclusion; Pregnant disabled women should not be discriminated and stigmatized especially by their spouses. This will lead to positive health seeking behavior during pregnancy and improved maternal and child outcomes. The government should improve the health care to be disability friendly