Usman Ibrahim Muhammad, Ruiter Robert A C, Dilana Schaafsma
Department of Work and Social Psychology, Maastricht University, Maastricht, Netherlands.
Department of Work and Social Psychology, Fontys University of Applied Sciences, Eindhoven, Netherlands.
Front Psychol. 2025 Aug 25;16:1562117. doi: 10.3389/fpsyg.2025.1562117. eCollection 2025.
Psychosocial disability (PSD) refers to the limitations experienced by persons with mental illness (PWMI) in interacting with their social environment. Persons with psychosocial disabilities (PPSD) face significant barriers to accessing sexual and reproductive health (SRH) services due to structural and institutional barriers. Despite commitments under the Convention on the Rights of Persons with Disabilities (CRPD), there are persistent rights violations and denial of PPSD to exercise their rights and access services related to SRH care. This study aimed to explore the multifaceted barriers and enablers influencing access to SRH for PPSD in Nigeria, drawing from the perspectives of caregivers, family members, and stakeholders in the communities where they live.
A qualitative study method was employed, using focus group discussions (FGDs). Sixty ( = 60) participants were purposively and conveniently selected to include caregivers, and family members of PPSD, and community actors' who are familiar with mental health issues and its related PSD. Responses were coded and analyzed thematically, guided by the socio-ecological framework.
The study reported key barriers to SRH access for PPSD, including limited mental health awareness, stigma, financial constraints, and poor healthcare infrastructure. Enablers included community awareness, financial support from informal networks, mobile outreach and staff training. Notably, the study revealed a unique culturally specific belief, such as mental illness being transmitted through breastfeeding or bringing fortune through sexual contact with affected women.
The study highlights critical and intersecting barriers to SRH access for PPSD in Nigeria, underscoring the need for inclusive, rights-based and support system friendly interventions addressing both community-level barriers and systemic health service gaps. The study found that caregivers' engagement and leverage of local structures within the community are essential for improving the interaction of PPSD with their physical environment and enhancing access to SRH services. Further study and SRH policy efforts must prioritize socio-cultural approaches that uphold the dignity and rights of PPSD in the community.
心理社会残疾（PSD）是指精神疾病患者（PWMI）在与社会环境互动中所经历的限制。由于结构和制度障碍，心理社会残疾者（PPSD）在获得性健康和生殖健康（SRH）服务方面面临重大障碍。尽管有《残疾人权利公约》（CRPD）的相关承诺，但PPSD的权利仍持续受到侵犯，其行使权利和获得与SRH护理相关服务的机会也被剥夺。本研究旨在从尼日利亚PPSD的照顾者、家庭成员以及他们所在社区的利益相关者的角度，探讨影响PPSD获得SRH服务的多方面障碍和促进因素。
采用定性研究方法，运用焦点小组讨论（FGD）。有目的地且方便地选取了60名参与者，包括PPSD的照顾者、家庭成员以及熟悉心理健康问题及其相关PSD的社区行为者。在社会生态框架的指导下，对回答进行编码并进行主题分析。
该研究报告了PPSD获得SRH服务的主要障碍，包括心理健康意识有限、耻辱感、经济限制和医疗基础设施差。促进因素包括社区意识、来自非正式网络的经济支持、流动外展服务和工作人员培训。值得注意的是，该研究揭示了一种独特的文化特定观念，例如认为精神疾病是通过母乳喂养传播的，或者与患病女性进行性接触会带来好运。
该研究强调了尼日利亚PPSD获得SRH服务的关键和交叉障碍，强调需要采取包容性的、基于权利的和支持系统友好型干预措施，以解决社区层面的障碍和系统性卫生服务差距。研究发现，照顾者参与并利用社区内的当地结构对于改善PPSD与他们的物理环境的互动以及增加获得SRH服务的机会至关重要。进一步的研究和SRH政策努力必须优先考虑维护社区中PPSD尊严和权利的社会文化方法。
