BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh.
BMJ Glob Health. 2020 Dec;5(12). doi: 10.1136/bmjgh-2020-002904.
Research has shown that persons with disabilities require greater sexual and reproductive health (SRH) care and services than persons without disabilities. However, this need is often neglected in most of the low-and-middle-income countries including Bangladesh. There is also a dearth of research and data relevant to this issue. A nationwide mixed-methods research has been conducted to explore persons with disabilities' specific sexual and reproductive health and rights (SRHR) needs, health seeking behaviour related to SRH and barriers in accessing SRH services, along with the associated factors that influence their SRH outcomes. The purpose of this paper is to discuss the challenges encountered by the researchers while conducting this research and the strategies adopted to resolve those challenges. Some of the challenges experienced by the researchers include development of appropriate tools with questions on sensitive SRHR topics, obtaining informed consent, difficulty to maintain privacy while exploring sensitive SRHR issues and communication difficulties when interviewing individuals with intellectual and sensory impairments. The mitigation strategies include iterative revisions of all tools based on multiple pretests in different filed sites and expert feedback, strategic rapport building and maintaining appropriate contextual etiquette while conducting the interviews. The reflections discussed in this paper will assist future researchers in understanding potential field challenges they might encounter in similar low resource settings while conducting research on SRHR and similar sensitive issues among marginalised population groups, such as persons with disabilities.
研究表明,与非残疾者相比,残疾者需要更多的性健康和生殖健康(SRH)护理和服务。然而,在包括孟加拉国在内的大多数中低收入国家,这种需求往往被忽视。与这一问题相关的研究和数据也很少。为了探索残疾者特定的性健康和生殖健康及权利(SRHR)需求、与性健康相关的求医行为以及获取性健康服务的障碍,以及影响他们性健康结果的相关因素,进行了一项全国性的混合方法研究。本文的目的是讨论研究人员在进行这项研究时遇到的挑战,以及为解决这些挑战而采取的策略。研究人员遇到的一些挑战包括制定关于敏感的 SRHR 话题的适当工具,获得知情同意,在探索敏感的 SRHR 问题时难以保护隐私,以及在采访智力和感官障碍者时的沟通困难。缓解策略包括根据不同现场的多次预测试和专家反馈,对所有工具进行迭代修订,在进行访谈时建立战略关系并保持适当的背景礼仪。本文所讨论的反思将有助于未来的研究人员了解他们在类似的资源匮乏环境中进行性健康和生殖健康以及类似的边缘化人群(如残疾者)的敏感问题研究时可能遇到的潜在现场挑战。