Maternal and newborn health needs for women with walking disabilities; “the twists and turns”: a case study in Kibuku District Uganda

Abstract

Background In Uganda 13% of persons have at least one form of disability. The United Nations’ Convention on the Rights of Persons with Disabilities guarantees persons with disabilities the same level of right to access quality and affordable healthcare as persons without disability. Understanding the needs of women with walking disabilities is key in formulating flexible, acceptable and responsive health systems to their needs and hence to improve their access to care. This study therefore explores the maternal and newborn health (MNH)-related needs of women with walking disabilities in Kibuku District Uganda. Methods We carried out a qualitative study in September 2017 in three sub-counties of Kibuku district. Four In-depth Interviews (IDIs) among purposively selected women who had walking disabilities and who had given birth within two years from the study date were conducted. Trained research assistants used a pretested IDI guide translated into the local language to collect data. All IDIs were audio recorded and transcribed verbatim before analysis. The thematic areas explored during analysis included psychosocial, mobility, health facility and personal needs of women with walking disabilities. Data was analyzed manually using framework analysis. Results We found that women with walking disabilities had psychosocial, mobility, special services and personal needs. Psychosocial needs included; partners’, communities’, families’ and health workers’ acceptance. Mobility needs were associated with transport unsuitability, difficulty in finding transport and high cost of transport. Health facility needs included; infrastructure, and responsive health services needs while personal MNH needs were; personal protective wear, basic needs and birth preparedness items. Conclusions Women with walking disabilities have needs addressable by their communities and the health system. Communities, and health workers need to be sensitized on these needs and policies to meet and implement health system-related needs of women with disability.

Barriers facing persons with disability in accessing sexual and reproductive health services in sub-Saharan Africa: A systematic review

“…Table 1 presents the characteristics of the eligible studies. Of the 26 eligible studies, 19 were qualitative in design [7,10,11,[18][19][20][31][32][33][34][35][36][37][38][39][40][41][42][43]; four used a survey design [44][45][46][47]; and three used mixed methods design [48][49][50]. The 26 studies were reported from twelve African countries: Uganda (seven studies) [7,10,31,32,34,37,39];…”

“…Lastly, two main economic barriers emerged from review of eligible studies. These included unaffordability of SRH services and information [18,37,49,54]; and general financial and resource poverty which hinder PWDs' access to SRH services and information [7,20,31,32,35,38,51].…”

‘They are my future’: childbearing desires and motivations among women with disabilities in Ghana - implications for reproductive healthcare

“…For many of the WWDs in our study, pregnancy and childbearing reaffirmed their feminine identity and sexuality as well as their self-worth as women. In previous studies, WWDs have commented on how becoming pregnant was experienced as an important achievement and affirmation of femininity, and how the experience of pregnancy confirmed that their biological bodies could function like those of women without disabilities [ 49 ]. Our findings particularly showed that being a mother and doing mothering were fulfilling life events for many WWDs - events that caused them (and others) to realize their abilities rather than disabilities [ 46 , 49 ].…”

“…In previous studies, WWDs have commented on how becoming pregnant was experienced as an important achievement and affirmation of femininity, and how the experience of pregnancy confirmed that their biological bodies could function like those of women without disabilities [ 49 ]. Our findings particularly showed that being a mother and doing mothering were fulfilling life events for many WWDs - events that caused them (and others) to realize their abilities rather than disabilities [ 46 , 49 ]. As the pronatalist orientation of our research context have tended to encourage childbearing among women as a marker of biological and social accomplishments, we are not surprised that many of our participants viewed childbearing as a means to self-actualisation.…”

“…Indeed, demographers and economists have historically found demand for labour and future economic insecurity as reasons underlying childbearing desires and intentions among men and women without disabilities [ 28 – 30 ]. Within disability studies, recent studies have similarly reported that many WWDs perceived having children as an investment for the future in terms of social support and labour provided by grown children [ 49 ]. In this study, many WWDs across different spatial contexts highlighted their economic vulnerability, and how childbearing may be the only way to achieve social acceptance and respectability as well as economic security.…”