Abstract
Objectivethere is little evidence about disabled women׳s access to maternal and newborn health services in low-income countries and few studies consult disabled women themselves to understand their experience of care and care seeking. Our study explores disabled women׳s experiences of maternal and newborn care in rural Nepal. Designwe used a qualitative methodology, using semi-structured interviews. Settingrural Makwanpur District of central Nepal. Participantswe purposively sampled married women with different impairments who had delivered a baby in the past 10 years from different topographical areas of the district. We also interviewed maternal health workers. We compared our findings with a recent qualitative study of non-disabled women in the same district to explore the differences between disabled and non-disabled women. Findingsmarried disabled women considered pregnancy and childbirth to be normal and preferred to deliver at home. Issues of quality, cost and lack of family support were as pertinent for disabled women as they were for their non-disabled peers. Health workers felt unprepared to meet the maternal health needs of disabled women. Key conclusions and implications for practiceintegration of disability into existing Skilled Birth Attendant training curricula may improve maternal health care for disabled women. There is a need to monitor progress of interventions that encourage institutional delivery through the use of disaggregated data, to check that disabled women are benefiting equally in efforts to improve access to maternal health care.
Highlights
IntroductionDisabled persons are estimated to constitute 15% of the world's population and a disproportionate percentage of the world's poor (WHO and The World Bank, 2011; Hosseinpoor et al, 2013; Mitra et al, 2013)
Disabled persons are estimated to constitute 15% of the world's population and a disproportionate percentage of the world's poor (WHO and The World Bank, 2011; Hosseinpoor et al, 2013; Mitra et al, 2013). Their inclusion in development efforts is essential for the attainment of the Millennium Development Goals (MDGs), but tracking progress among disabled people is difficult as disaggregated data are often unavailable (WHO and The World Bank, 2011)
Equity analyses of MDG targets for maternal and child health have been useful in highlighting inequalities in access to life saving interventions between rich and poor (Barros et al, 2012), and there is little evidence regarding the access of disabled women to reproductive health services in low income countries
Summary
Disabled persons are estimated to constitute 15% of the world's population and a disproportionate percentage of the world's poor (WHO and The World Bank, 2011; Hosseinpoor et al, 2013; Mitra et al, 2013). Their inclusion in development efforts is essential for the attainment of the Millennium Development Goals (MDGs), but tracking progress among disabled people is difficult as disaggregated data are often unavailable (WHO and The World Bank, 2011).
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