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People with disabilities want to participate in sexual and reproductive health care

Representatives of people with disabilities on World Population Day. They called for the inclusion of sexual and reproductive health. (Mercy Kahenda, Standard)

Persons with disabilities have called on the Ministry of Health to combat discrimination in access to maternity and sexual reproductive health services.

Esther Mkamori, programme manager at United Disabled Persons of Kenya, said it was worrying that most women who wish to give birth undergo a caesarean section without examination due to their physical disability.

She said that a large proportion of maternity wards do not have adjustable delivery beds for people with disabilities. Most hospitals’ maternity ward equipment, such as weighing scales, is also not suitable for people with disabilities.

“Unfortunately, pregnant women with disabilities prefer to give birth at home with the help of traditional birth attendants because the facilities in hospitals are not suitable for them and some are afraid of how they will be treated by doctors. In hospitals, some give birth on the floor,” said Mkamori.

Communication also represents an obstacle to access to health services.

“We report numerous cases of forced abortions, sterilizations and prescription of contraceptives to people with disabilities, especially those with intellectual disabilities,” Mkamori added.

“We need solid data on the number of people with disabilities so that we can plan for them. For example, the government knows how many maternity beds it needs to set up and also knows what type of disability they qualify for so that they can get assistance,” noted Boniface Agola, representative of the Health Education Infrastructure Disability Inclusion Consortium (HEIDI).

HEIDI Chair Jane Ndenga said there was a need to raise public awareness of the sexual and reproductive health rights of women and girls with disabilities, as well as the consequences of discrimination, which include maternal mortality, child mortality, severe disabilities, the disproportionately high rate of HIV/AIDS infection, mental illness and sexual and gender-based violence.

On the occasion of World Population Day, politicians said the government should pay attention to discrimination against women with disabilities in the provision of sexual and reproductive services and take immediate policy and programmatic measures to end this discrimination.

Jane Kihungi, Executive Director of Women Challenged to Challenge (WCC), added that political protests and climate shocks also affect women and girls with disabilities seeking medical services.

During the floods, for example, “restricted freedom of movement in terms of sexual and reproductive health made it impossible to access reproductive health services, be it maternity or family planning services. Humanitarian situations that prevent people with disabilities from working usually lead to increased sexual and gender-based violence, and the flood period was no exception,” she said.

Similarly, the violent turn of the protests has resulted in women and girls with disabilities living in protest-affected areas staying stationary on protest days for fear of being caught up in the violence.

“This means that visits to health facilities to receive sexual and reproductive health services will be suspended,” Kihungi added.

Citing two recent studies on the state of sexual and reproductive health of women and girls with disabilities, the politicians emphasize the extent to which women and girls with disabilities are disadvantaged with regard to general services and rights in the area of ​​sexual and reproductive health.

The WCC’s first study on sexual and reproductive health rights (SRHR) of women with disabilities was conducted in Siaya, Nairobi and Homa Bay.

The study conducted in 2021 found that while Kenya has a sophisticated policy and legal framework to promote sexual and reproductive health rights, women with disabilities face a variety of SRHR issues and challenges.

“Challenges include relationships, access to and availability of disability-friendly SRH services, stigma and discrimination,” said

“Respondents feel that gender-based violence and abuse against women and girls with disabilities is widespread in the community and that perpetrators of sexual and gender-based violence are generally known to survivors,” said Dr Josephta Mukobe, WCC Executive Secretary.

She added: “The study found that there is little awareness and knowledge about strategies to provide SRHR information and services to women and girls with disabilities.

Kenyatta University’s second study on evidence on sexual and reproductive health rights of women with disabilities was published in 2021. The study limited its scope to the use of family planning services by women with disabilities in Kajiado.

According to the study, which was conducted among 200 women with disabilities, 68 percent of respondents had not used family planning services, while 32 percent had already used these services.

As many as 28.3 percent of respondents refrained from family planning for fear of complications during use, followed by 17.7 percent who cited the desire to have children and religious prohibitions as reasons for not using the method.

It was found that 57 percent of women had little information about family planning methods, while 43 percent were very well informed about these methods.

More than half (54 percent) of non-working women did not use any family planning services.

In addition, 58.1 percent of respondents who suffered from a physical disability did not use family planning services.

Alice Munala, program officer at WCC, said health care providers across the country have been trained in sign language to facilitate access to health care for people with disabilities.

“We have trained health workers, including police officers, teachers and police chiefs, in communication,” Munala said.

“A person with a disability is like anyone else. Nothing prevents them from exercising their sexual rights. That is why we must give them access to health care.”