Let's ensure contraceptive accessibility for people with special needs

By Geofrey Kasumba

On June 19, while carrying out a family planning outreach at Buhehe health centre III in Busia district I was touched by the story of Anyango Mary,Mary is  a 30 year old  blind woman,she came to the health facility accompanied with her grandparent mzee Sidaze aged 87.

Men in Buhasaba subcounty always wanted to engage Mary in sexual practices and that's why her grandparent decided to opt for family planning, what caught my attention is that the health workers at the facility had no skills in sign language to help them know the family planning choice that Mary would want and they applied the choice they felt, am not sure whether she even knew she they had even inserted an implant to her for family planning.

Despite having a national policy on disability and the Persons with Disabilities Act, many women in Uganda with disabilities face many barriers in accessing reproductive health services including contraception.

As a result, the unmet need for family planning, which is the number of women who would like to space, limit or stop childbearing, but lack access to methods for doing so, is high among women with disabilities.

Contraception has been identified as an imperative for achieving the Sustainable Development Goals. In poor countries, the need for contraception is highest among the most vulnerable population groups. One such group is women with disabilities.

Irrespective of the form or stage at which a disability occurs, it is a serious cause of exclusion of people directly affected by it and/or their families not only because it carries negative and derogative connotations in many societies, but also because it can significantly affect individual and family economic and social functions for a long time.

Disability is one of the major obstacles to uptake of reproductive health services in sub-Saharan Africa because persons having disabilities are perceived to be a sexual and unlikely to marry or bear children.

The International Conference on Population and Development recognizes explicitly calls for governments at all levels to consider the needs and rights of persons with disabilities and to eliminate discrimination against persons with disabilities with regard to reproductive rights and household and family formation.

Women with special needs encounter various social, attitudinal and physical barriers to accessing safe motherhood and reproductive health services.  women with disability are marginalised by societal perceptions ‘should not be sexually active' which perceptions influence the way disabled people are treated in the community on issues of sexual reproductive health and to the extent of withholding sex education on the assumption that persons with disability ‘wouldn't need it'.

Pervasive discrimination against women with disabilities in matters related to sexuality, fuelled by the perception that they do not need contraception because they are asexual and their inadequate knowledge contributes to the low uptake of reproductive health services.

Access to RH services and information is generally inadequate for the entire population. It is believed that access is poorer for People With Disabilities (PWDs), who prefer services of traditional healers to those of health institutions, due to unfavorable attitudes.

In my views I think a special family planning needs programme is urgently needed to address this problem for both people with special needs and all family planning focal persons plus all health facilities countrywide if we are to achieve the family planning costed implementation plan 2020 targets for Uganda.

Health facilities should also design outreach days where they go direct to the homes of people with disabilities, imagine the distances these people trek to access services with the financial constraints they face.

The government and the concerned organizations should create awareness among women with disabilities and the local community. This helps inform the women with disabilities their reproductive health rights and where to get RH services Awareness should be aimed at informing women with disabilities about the reproductive health services in place and where and when to get them.

It should also be aimed at doing away with stigma attached to the nature of disability among the community members. This can help women with disabilities to break the negative social image and enable the service providers and the community to be more friendly to rural women with disabilities.

The writer is a knowledge management specialist Uganda Health Marketing Group