In a country where persons with disabilities are not fully accepted as part of the community in which they reside, they are often left out of education on sexual reproductive health and family planning. The thought here is that once they are disabled, their sexual life or reproductive health is equally disabled.
At a recent workshop at the La Palm Hotel in Accra the capital city of Ghana, organised by the United Nations Population Fund (UNFPA) in collaboration with the Ghana Federation of Disability Organisations (GFD), I together with members of other organizations and institutions such as the Ministry of Health discussed ways of improving access to sexual reproductive health/family planning information and services for persons with disabilities.
A general look at the statistics in the country indicates that 10% of the Ghanaian population is made up of persons with disabilities and the literacy rate among these PWDs is not more than 3%.
“I visited the clinic when I was pregnant with my fourth child. The nurses said very hurtful things to me. They said I was giving birth like a dog. They said they pitied the men who introduced me to sex because I was no longer able to control my sexual feeling. I will never go back to that clinic“… 33 year old mother with a physical disability.>> Quote from Rugoho and Maphosa, 2017.
“I went to look for family planning methods at the clinic and the nurses told me sex was not meant for the disabled, hence there was no need for me to get contraceptive methods“… 29 year old pre-school teacher with a physical disability.>> Quote from Rugoho and Maphosa, 2017.
These are comments levelled against PWDs all over the world when they visit the clinic to access sexual reproductive health education and family planning methods. Unfortunately, women with disabilities are more likely to suffer sexual, emotional and physical abuse (Groce et al 2009) due to their vulnerability as a result of their disabilities… (Rugoho and Maphosa, 2015)
Participants at the workshop were divided into six groups representing the six health system building blocks, according to the World Health Organisation (W.H.O). The objective was to discuss the challenges faced by PWDs in accessing sexual reproductive health and family planning, find out the key drivers to these challenges and bring out solutions to them.
The W.H.O health system building blocks are:
– Service delivery.
– Health workforce.
– Information and research.
– Medical products and technologies.
– Health care financing.
– Leadership and governance.
Challenges raised by the groups included the perception that PWDs are non-sexual, negative service provider attitudes towards PWDs and the wrong notion that PWDs will give birth to their kind and so should be discouraged from participating in sexual activities and reproduction. A research finding by “Holness” in 2013 revealed that women in some countries including some in Africa are forced to undergo sterilization. The policy and legal framework is inadequate to ensure the kind of access envisaged under the UNCRPD and to some extent the Ghana Disability Law (Act 715, 2006). It is also key to note that the legal framework to aid physical access of PWDs to facilities such as hospitals, clinics and other health centres in Ghana is not fully implemented.
Some of the proposed solutions include the rigid enforcement of the provision of the national Disability Law on access to PWDs to public places and buildings, review of the law, and spell out specific rights to PWDs to sexual reproductive health and family planning with proper guidelines for implementation with accompanying legislative instruments. Also suggested was to create social media platforms for PWDs for effective sexual reproductive health and family planning information as well as service delivery.
Health training institutions should integrate special courses on dealing with PWDs (including the use of sign language) and attitudinal changes regarding PWDs and SRH/FP Service delivery.
Did you know that in 1941 the 37 Military Hospital was built to serve PWDs only? Did you know that after four years it was turned into a general hospital? This was even before Ghana gained independence. Can you imagine the level of success the nation would have achieved if we had built on what was started more than 7 decades ago?
Let us fight the exclusion of PWDs from the radar of livelihood. Let us take off from this point in our discussions, refusing to re-visit these issues but making sure that we address what needs to be addressed and implement what needs to be implemented or else we will keep going around in circles as we have been doing in the last seven decades.
Christopher Agbega is an ambitious young man living above his physical disability with the hope of making his country Ghana and the world a better place for persons with disabilities. A member of Sharecare Ghana and an advocate for persons with auto-immune and neurological conditions, Chris is also a hip-hop artiste, a song writer, radio presenter and a social media marketer.