Access for Women with Disabilities to Sexual and Reproductive Health Services in Lira, Northern Uganda: Experiences, Obstacles and Strategies

This study seeks to understand the different challenges women with disabilities face in accessing sexual and reproductive health services, taking the case of Lira in Northern Uganda, as a case study. The study will be informed by the following key concepts: gender, disability, sexuality and the principle of access for all women to sexual and reproductive health care services. The concepts also include an element of class, since intersectionality shows that women without education and with a low level of economic security are the most vulnerable to not being able to fully access sexual and reproductive health care services. An intersectional approach highlights the hidden factors, such as psychological and physical health problems, internalized and others’ stereotypes, negative body images, biological constrains, socio cultural beliefs, attitudes and relationships, as well as educational and even identity factors. To address these questions, fieldwork was conducted in Lira in July 2015, and interviews were conducted with fourteen women with disabilities, contacted through snowball sampling, to gain insights into their different experiences, which I was concerned to hear from them directly rather than from ‘experts’ who might talk on behalf of disabled women. I also spoke with two District health officials, in order to facilitate the research process, but also to understand the official policies in place and what services the District offers in general in terms of sexual and reproductive health services. One of the officials provided me with activity reports, which were analyzed to see whether women with disabilities were identified as a target group for health care programs, or not. A third key interview was with a representative of NUWODU, the Ugandan national union of women with disabilities, who informed me of the importance of Gender-based violence in their advocacy program was unable to estimate the number of women with disabilities in the District from any of these sources. Yet the fourteen interviews I conducted with the women themselves went well, and revealed that they faced a number of different challenges, which this study identifies. The key challenges were discrimination, and stigma within the community, including health staff, in relation to disabled women’s sexuality. Overall this study concludes that more needs to be done to design specific programs to deal with the diversity of sexual and reproductive health needs of this vulnerable, yet fully entitled, group of women, and for strategies to improve the access of women with disabilities to sexual and reproductive health services to be realized, more collaboration may be needed between NUWODU, the women themselves and local government staff responsible for provision of health care services.