The power of data

We know all too well that healthcare inequalities exist worldwide, particularly for people with disabilities. And this is especially true when it comes to Sexual and Reproductive Health (SRH) services.

The 2030 Sustainable Development Goals (SDGs) are great markers for tracking progress towards a fairer, more inclusive world. And a couple of those goals include targets around gender equality and sexual and reproductive rights. SDG 5 is focused on “achieving gender equality and empower all women and girls”. And SDG 3, “good health and wellbeing”, includes targets around ensuring universal access to sexual reproductive rights and health is guaranteed to all.

So as part of this, women and girls need to: 

• Have the opportunity to make informed decisions about the kinds of contraceptives they want to use.
• Have the right to decide if and who they want to have sexual relationships with. 
• Be able to freely choose the kind of reproductive healthcare they want to receive. 

This goal also factors in the need for countries to develop and implement laws and policies that ensure that women and girls have access to SRH services. As well as vital education and information.

So why is this important?

There are many benefits to providing access to SRH services. And to guarantee that women have the right to choose what is best for them and their bodies. This would empower them and save lives. But it would also enable them to pursue their education and careers. However, it is estimated that globally 218 million women and girls, with and without disabilities, currently do not have access to contraception. Even though they would want to. 35 million women and girls resort to unsafe abortions, and 22,000 of them die due to having an unsafe abortion.

Women and young girls worldwide face many hardships in accessing SRH services. And this is even more prominent for women and youth with disabilities. This is because communities have misconceptions and negative attitudes towards women with disabilities. They discriminate against them. And even often believe that they should not be allowed to have their own families. This, in turn, can affect women with disabilities accessing services. 

Some of the barriers that women with disabilities can face include:

• Pregnant women with disabilities are often turned away. Healthcare providers often shame them for becoming pregnant in the first place. 
• Women with disabilities will not be given the right to choose whether they want a family or not. They are brought to family planning clinics by families to be given a contraceptive to prevent them from getting pregnant.

Information relating to different methods of contraception and benefits/side effects are often not accessible for women with different types of disabilities. Facilities are often not physically accessible for women with disabilities. 

Getting a clearer picture

We wanted to do some research to understand the experiences of women with disabilities when it comes to SRH access. And find out if there are disparities between women with and without disabilities.

Since 2018, Leonard Cheshire has been working on the Women’s Integrated Sexual Health (WISH) lot 1 project, a three-year project. WISH is the UK government’s flagship programme which aims to strengthen support for SRH and rights in African and Asian countries. We’ve been providing technical assistance and leadership to the consortium. And we’ve been helping them develop disability-inclusive sexual and reproductive health services. That way, women with disabilities have better access to SRH services. 

And through our research, we’ve been able to get more of an understanding of the state of play in Sub-Saharan Africa. We looked at secondary data from eleven countries from demographic and health surveys (DHS).

We looked closely at some SRH indicators, including: 

• Accessing healthcare facilities, 
• Accessing contraceptives and specifically modern, safe methods of contraception 
• Assessing the demand for family planning 
• Identifying any SRH needs not currently being met

 We often talk about how there’s a distinct lack of disability data. And this is something we’re looking to address in the Global Disability Summit next year. And a lack of data was no exception here. Looking at household and women’s health surveys, we found that not all countries had disability data to cross compare with SRH data. And that made it challenging to assess healthcare inequalities accurately. 

However, we were able to look at Mali, Senegal and Nigeria. These countries used high quality measures of disability data, like the Washington Group Questions. Our analysis told us several things, including the fact that a higher percentage of women with disabilities used any method of contraception in Mali, including traditional and folkloric (19%) compared to women without disabilities (17%). But in Nigeria and Senegal, a lower percentage of women with disabilities reported using modern contraceptive methods than women without disabilities.

We uploaded the data we found onto The Disability Data Portal. You can take a look at it in more detail. But the information we found is really just a snapshot into SRH. 

Why we need more data

We need more data to give us insights into healthcare disparities. And things like surveys and censuses need to include more questions around disability. That way, we can have more accurate data to help effect real policy change and ensure people with disabilities are included. And in turn, we can work to meet the needs of women with disabilities better.

That way, we can break down the stigmas and misconceptions entrenched in disability and sexual and reproductive health that are preventing women from disabilities from accessing the support they rightly deserve.