On Tuesday 26 September, the international community celebrates World Contraception Day.
The event aims to improve the awareness of contraception and enable young people to make informed choices on their sexual and reproductive health.
There is compelling evidence that shows how improving global access to low-cost contraception and its uptake through family planning programmes can:
Current estimates indicate that 379 million women in low and middle income countries are using modern contraceptive methods, equivalent to one-third of all women of reproductive age. This is 95 million more women than a decade ago.
Sightsavers promotes inclusive health because we believe everyone should be able to receive quality, affordable health care.
About our workDespite this clear progress, young women and adolescent girls with disabilities continue to experience barriers in accessing voluntary contraception and family planning services.
For example, evidence shows that women with disabilities experience lower coverage of modern contraceptives (44%) compared to women without disabilities (48%). The gap is even larger in South Asia: 48% versus 59%. Similarly, adults with disabilities in sub-Saharan Africa are less likely to have comprehensive knowledge about HIV prevention and transmission (23%) compared to people without disabilities (33%).
Widespread stigma and discrimination related to the intersection of gender and disability are also major barriers that prevent women and girls with disabilities from exercising their sexual and reproductive health and rights (SRHR). These are further compounded by limited access to accessible and inclusive information, limited knowledge of disability inclusion among health workers, infrastructural barriers within health facilities, direct and indirect costs of services and contraceptive products, and discriminatory policies.
It is important to understand that these are not isolated issues. As highlighted in the recent WHO global report on health equity for people with disabilities, these barriers are part of a wider systemic failure of health systems and societal factors, which result in people with disabilities – particularly women and girls – experiencing severe health inequities and worse health outcomes compared to the rest of the population.
Access to contraception is crucial – but is not sufficient.
This year’s World Contraception Day theme, ‘The Power of Options’, is particularly significant, as it shines a spotlight on the fundamental role that contraceptive choices play in empowering individuals to take control of their reproductive health, fostering autonomy and enabling informed choices.
Yet adolescent girls and young women with disabilities have been systematically denied the opportunity to exercise their bodily autonomy and make free and informed reproductive choices. Evidence shows that people with disabilities – particularly women and girls – are often subjected to forced contraception and sterilisation due to persistent stigma within communities and the idea that people with disabilities should not have children.
This is a severe violation of international law – specifically, Article 23 of the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD), which affirms the right of people with disabilities to make free and informed decisions about their sexual and reproductive health.
One of Sightsavers’ priority objectives in its social inclusion strategy is to ensure that people with disabilities are empowered and given the necessary tools to make informed decisions on an equal basis with others, particularly when it comes to their sexual reproductive health and rights.
That is why we are making strategic and targeted investments across multiple countries to advance SRHR for people with disabilities.
For example, in Nigeria, thanks to funding from UK aid and the Inclusive Futures programme, we are running a £2.3 million inclusive family planning project in partnership with BBC Media Action, national organisations of people with disabilities and government partners.
Sightsavers attended the Women Deliver conference in Kigali, Rwanda, to call for women with disabilities to be included in all discussions of gender equity.
Read the blogThrough this initiative, we aim to advance universal health coverage by tackling the health inequities that people with disabilities face when exercising their SRHR.
The project is implementing a comprehensive, inclusive and accessible social and behaviour change strategy. It aims to reach approximately four million people through a radio drama, factual radio programming, a digital communications campaign and interpersonal communication activities at a community level. All these activities focus on reaching women and girls with disabilities, husbands, family members and religious leaders.
The project has also completed accessibility audits of 24 public and private SRHR facilities in Kaduna state, provided in-person disability inclusion and gender equity training for more than 1,000 service providers and is supporting organisations of people with disabilities to advocate for the National Policy on SRHR of Persons with Disabilities to be adopted and integrated in Kaduna state.
Sightsavers is also the disability partner in the West and Central Africa consortium led by MSI Reproductive Choices as part of the Women’s Integrated Sexual Health (WISH) programme, UK aid’s flagship SRHR programme.
To contribute to the ‘leave no one behind’ agenda, the WISH programme has been reaching women with disabilities whose needs were previously largely unmet through family planning and sexual reproductive health service provision. Through this programme, we are providing expertise to fellow consortium members to enhance disability-inclusive practices with the goal to:
We are also working with partners to bridge existing gaps. For example, Sightsavers developed a training package to train SRHR healthcare providers and other stakeholders such as the Ministry of Health on how to seek informed consent and safeguard people with disabilities from marginalised communities.
“Enhancing access to sexual and reproductive health and rights for women with disabilities has been at the core of the WISH programme, and all consortium partners have made huge progress to achieve this goal. MSI is proud to see how disability inclusion is now a key part of our programming.”
Caroline Guinard, FCDO programme director
MSI Reproductive Choices
The sexual and reproductive health and rights of people with disabilities – particularly women and girls with disabilities – have been ignored for too long. If we are serious about leaving no one behind, now is the time to act. It is vital that we:
All of this requires a collective effort, on World Contraception Day – and every other day.
Authors
Andrea Pregel is Sightsavers’ global technical lead for inclusive health, and Amalie Quevedo is Sightsavers’ technical advisor for inclusive sexual and reproductive health and rights.
Let’s work together! If you want to know more about Sightsavers’ inclusive SRHR work, or want to explore opportunities for collaboration, please contact Andrea Pregel at [email protected]
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