Abstract
IntroductionDespite the universal right to access the same range, quality and standard of free or affordable health care and programs as provided to other persons, people with physical disabilities (PWPDs) continue to experience challenges in accessing these services. This article presents the challenges faced by PWPDs in accessing sexual and reproductive health (SRH) services in Kampala, Uganda.MethodsThis was a qualitative study that was conducted with male and female PWPDs in Kampala in 2007. Data on the challenges experienced by PWPDs in accessing SRH services were collected using in-depth interviews with 40 PWPDs and key informant interviews with 10 PWPDs’ representatives, staff of agencies supporting PWPDs and health workers. All data were captured verbatim using an audio-tape recorder, entered into a Microsoft Word computer program and analyzed manually following a content thematic approach.ResultsThe study findings show that PWPDs face a multitude of challenges in accessing SRH services including negative attitudes of service providers, long queues at health facilities, distant health facilities, high costs of services involved, unfriendly physical structures and the perception from able-bodied people that PWPDs should be asexual.ConclusionPeople with physical disabilities (PWPDs) face health facility-related (service provider and facility-related challenges), economic and societal challenges in accessing SRH services. These findings call for a need to sensitize service providers on SRH needs of PWPDs for better support and for the government to enforce the provision of PWPD-friendly services in all health facilities.
Highlights
Despite the universal right to access the same range, quality and standard of free or affordable health care and programs as provided to other persons, people with physical disabilities (PWPDs) continue to experience challenges in accessing these services
A higher proportion of females were better educated (75% of female PWPDs had secondary or higher levels of education compared to 65% among male PWPDs) and engaged in small businesses than their male counterparts
The findings suggest a need to sensitize the general public about sexual and reproductive health (SRH) needs and rights of PWPDs including educating the general public that save for their physical disability, PWPDs are as normal as other able-bodied people and should have equal access to the same services enjoyed by able-bodied persons
Summary
Despite the universal right to access the same range, quality and standard of free or affordable health care and programs as provided to other persons, people with physical disabilities (PWPDs) continue to experience challenges in accessing these services. In a study on the health care access and support for disabled women in Canada, Gibson and Mykitiuk [9] found that health system policies and practices reflect erroneous assumptions about what disabled people can or should do and that disabled women were often discouraged from having children either because of doubts regarding their capacities to provide care or because of concerns regarding the risks of the child inheriting a hereditary condition These findings suggest that despite the call for universal access to reproductive health services at the 4th International Conference on Population and Development in Cairo in 1994 [10] and the right to access “the same range, quality and standard of free or affordable health care and programs as provided to other persons” [1], access to sexual and reproductive health (SRH) services by PWDs remains a critical challenge. The reduced status of PWDs and the equation of sexuality to being normal and not disabled [1] add up to an orientation towards the denial of SRH services to PWDs [12]
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