Lee Kira, Devine Alexandra, Marco Ma Jesusa, Zayas Jerome, Gill-Atkinson Liz, Vaughan Cathy
Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, 3010, Australia.
Social Development Research Centre, De La Salle University, 2401 Taft Avenue, 1004, Manila, Philippines.
BMC Womens Health. 2015 Oct 15;15:87. doi: 10.1186/s12905-015-0244-8.
The Philippines has ratified the United Nations Convention on the Rights of Persons with Disabilities and recently passed domestic legislation protecting the sexual and reproductive rights of people with disability. However women in the Philippines continue to report barriers to sexual and reproductive health services, and there is limited empirical evidence available to inform policy makers' efforts to respond. This study aims to contribute to the available evidence by examining service providers' perceptions of disability and their experiences providing sexual and reproductive health services to women with disability.
The study was conducted as part of a larger three-year program of participatory action research that aims to improve the sexual and reproductive health of women with disabilities in the Philippines. Fourteen in-depth interviews and two focus group discussions were conducted with a total of thirty-two sexual and reproductive health service providers in Quezon City and Ligao. Qualitative data were analysed to identify key themes in participants' discussion of service provision to women with disability.
Analysis of service providers' accounts suggests a range of factors undermine provision of high quality sexual and reproductive health services to women with disability. Service providers often have limited awareness of the sexual and reproductive health needs of women with disability and inadequate understanding of their rights. Service providers have had very little training in relation to disability, and limited access to the resources that would enable them to provide a disability inclusive service. Some service providers hold prejudiced attitudes towards women with disability seeking sexual and reproductive health services, resulting in disability-based discrimination. Service providers are also often unaware of specific factors undermining the health of women with disability, such as violence and abuse.
Recent legislative change in the Philippines opens a window of opportunity to strengthen sexual and reproductive health service provision across the country. However the development of services that are disability-inclusive will require substantial efforts to address supply-side barriers such as prejudiced service provider attitudes and limited capacity. Disability inclusion must be prioritised for the national goal of responsible parenthood and reproductive health to be realised for all.
菲律宾已批准《联合国残疾人权利公约》，并于近期通过了保护残疾人性健康和生殖权利的国内立法。然而，菲律宾女性仍在报告获得性健康和生殖健康服务时面临障碍，且可供政策制定者参考的实证证据有限。本研究旨在通过考察服务提供者对残疾的看法以及他们为残疾女性提供性健康和生殖健康服务的经历，为现有证据提供补充。
本研究是一项为期三年的参与式行动研究项目的一部分，该项目旨在改善菲律宾残疾女性的性健康和生殖健康。在奎松市和利高市，对32名性健康和生殖健康服务提供者进行了14次深度访谈和2次焦点小组讨论。对定性数据进行分析，以确定参与者在讨论为残疾女性提供服务时的关键主题。
对服务提供者叙述的分析表明，一系列因素妨碍了为残疾女性提供高质量的性健康和生殖健康服务。服务提供者通常对残疾女性的性健康和生殖健康需求认识有限，对她们的权利理解不足。服务提供者接受的与残疾相关的培训很少，获得使他们能够提供包容性残疾服务的资源的机会也有限。一些服务提供者对寻求性健康和生殖健康服务的残疾女性持有偏见态度，导致基于残疾的歧视。服务提供者往往也没有意识到一些影响残疾女性健康的特定因素，如暴力和虐待。
菲律宾最近的立法变革为加强全国性健康和生殖健康服务提供了一个机会窗口。然而，要发展包容性残疾服务，需要做出大量努力来消除供应方障碍，如服务提供者的偏见态度和能力有限等问题。为了实现全民负责任生育和生殖健康的国家目标，必须将包容性残疾纳入优先事项。
