Centre for Health Equity, The University of Melbourne, Melbourne, Vic., Australia.
Nossal Institute for Global Health, The University of Melbourne, Melbourne, Vic., Australia.
Am J Community Psychol. 2020 Dec;66(3-4):370-380. doi: 10.1002/ajcp.12468. Epub 2020 Oct 20.
People with disabilities experience health disparities arising from social, environmental, and system-level factors. Evidence from a range of settings suggests women with disabilities have reduced access to health information and experience barriers to screening, prevention, and care services. This results in greater unmet health needs, particularly in relation to sexual and reproductive health. Women with disabilities are also more likely to experience physical and sexual violence than women without disabilities, further undermining their health. Community-based participatory research (CBPR) can generate knowledge and underpin action to address such health disparities and promote health equity. However, the potential and challenges of disability inclusion in CBPR, particularly in contexts of poverty and structural inequality such as those found in low- and middle-income countries, are not well documented. In this paper, we reflect on our experience of implementing and evaluating W-DARE, a three-year program of disability-inclusive CBPR aiming to increase access to sexual and reproductive health and violence-response services for women with disabilities in the Philippines. We discuss strategies for increasing disability inclusion in research and use a framework of reflexive solidarity to consider the uneven distribution of the benefits, costs, and responsibilities for action arising from the W-DARE program.
残疾人由于社会、环境和制度层面的因素而面临健康方面的差异。来自各种环境的证据表明，残疾妇女获取健康信息的机会减少，并且在接受筛查、预防和护理服务方面存在障碍。这导致她们未满足的健康需求更大，特别是在性健康和生殖健康方面。残疾妇女比非残疾妇女更有可能遭受身体和性暴力，这进一步损害了她们的健康。基于社区的参与式研究（CBPR）可以产生知识，并为解决这些健康差异和促进健康公平提供支持。然而，残疾包容在 CBPR 中的潜力和挑战，特别是在贫困和结构性不平等的情况下，如在低收入和中等收入国家中发现的情况，并没有得到很好的记录。在本文中，我们反思了我们在实施和评估 W-DARE 方面的经验，W-DARE 是一个为期三年的残疾包容 CBPR 项目，旨在增加菲律宾残疾妇女获得性健康和生殖健康以及暴力应对服务的机会。我们讨论了在研究中增加残疾包容的策略，并使用反思性团结框架来考虑 W-DARE 项目所产生的利益、成本和行动责任的不平衡分配。
