Abstract
BackgroundThe Philippines has ratified the United Nations Convention on the Rights of Persons with Disabilities and recently passed domestic legislation protecting the sexual and reproductive rights of people with disability. However women in the Philippines continue to report barriers to sexual and reproductive health services, and there is limited empirical evidence available to inform policy makers’ efforts to respond. This study aims to contribute to the available evidence by examining service providers’ perceptions of disability and their experiences providing sexual and reproductive health services to women with disability.MethodsThe study was conducted as part of a larger three-year program of participatory action research that aims to improve the sexual and reproductive health of women with disabilities in the Philippines. Fourteen in-depth interviews and two focus group discussions were conducted with a total of thirty-two sexual and reproductive health service providers in Quezon City and Ligao. Qualitative data were analysed to identify key themes in participants’ discussion of service provision to women with disability.ResultsAnalysis of service providers’ accounts suggests a range of factors undermine provision of high quality sexual and reproductive health services to women with disability. Service providers often have limited awareness of the sexual and reproductive health needs of women with disability and inadequate understanding of their rights. Service providers have had very little training in relation to disability, and limited access to the resources that would enable them to provide a disability inclusive service. Some service providers hold prejudiced attitudes towards women with disability seeking sexual and reproductive health services, resulting in disability-based discrimination. Service providers are also often unaware of specific factors undermining the health of women with disability, such as violence and abuse.ConclusionRecent legislative change in the Philippines opens a window of opportunity to strengthen sexual and reproductive health service provision across the country. However the development of services that are disability-inclusive will require substantial efforts to address supply-side barriers such as prejudiced service provider attitudes and limited capacity. Disability inclusion must be prioritised for the national goal of responsible parenthood and reproductive health to be realised for all.
Highlights
The Philippines has ratified the United Nations Convention on the Rights of Persons with Disabilities and recently passed domestic legislation protecting the sexual and reproductive rights of people with disability
Data presented in this paper were collected as part of W-DARE (Women with Disability taking Action on REproductive and sexual health), a three-year action research project aimed at improving access to quality sexual and reproductive health (SRH) information and services, including the prevention of violence, for women and girls with disability in the Philippines
The negative perceptions of some service providers was evident in their use of words such as “deficient”, “broken” and “inadequate” to describe people with disability, who were contrasted with “normal” people without disability
Summary
The Philippines has ratified the United Nations Convention on the Rights of Persons with Disabilities and recently passed domestic legislation protecting the sexual and reproductive rights of people with disability. Women with disability are acknowledged as experiencing unique and additional disadvantage because of intersectional discrimination associated with their gender and disability, resulting in a higher likelihood of experiencing exclusion compared with men with disability or women without disability [3,4,5] This exclusion compromises a number of life outcomes for women with disability including education, employment, and attainment of health, including sexual and reproductive health (SRH). The Global context The United Nations Convention on the Rights of Persons with Disabilities (CRPD) has specific provisions that recognise the reproductive rights of persons with disability (Art. 23); the right of people with disability to access SRH information and services (Art. 25); and the specific need for empowerment of women with disability (Art. 6) [6] In order for these rights to be achieved, women with disability need to be provided with age appropriate, accessible information on SRH, and to have recognition of their rights to have a sexual relationship, marry, establish a family, enjoy reproductive health, and physical integrity [7, 8]
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