Sexual and reproductive health

Persons with disabilities are often marginalised in terms of access to sexual and reproductive health (SRH) services, due to lack of knowledge or awareness about their needs, stigmatising attitudes, or an assumption that they are not sexually active and/or do not desire or cannot have children.

Where persons with disabilities experience increased vulnerability to sexual violence and abuse, their SRH education and care needs may be greater than those experienced by persons without disabilities. The United Nations Convention on the Rights of Persons with Disabilities addresses rights around sexual and reproductive health including in Article 9 (Accessibility), Article 16 (Freedom from exploitation, violence and abuse), Article 23 (Respect for home and the family) and Article 25 (Health).

Specifically, this requires: eliminating discrimination in all matters related to marriage, family, parenthood and relationships; ensuring control and retention of fertility on an equal basis as other people; providing access to the same standards and quality of care for sexual and reproductive health and related programs and services as provided to other people; and taking of appropriate measures to protect persons with disabilities from all forms of exploitation, violence and abuse, including gender-based aspects.

Resources below explore the approaches, principles and practices which can support effective disability inclusive sexual and reproductive health programmes.

See also: Violence Against Women and Girls with Disabilities.

Leonard Cheshire (2021) Working together for inclusive sexual and reproductive health

This report presents a comprehensive package of information, guidance and practical tips for sexual and reproductive health (SRH) services and programs. The report also outlines the human rights imperatives underpinning disability-inclusive SRH services and describes the important role of OPDs in designing and supporting the implementation of such services.

MSI & Leonard Cheshire (2020) Community engagement for inclusive sexual and reproductive health: A guide for conducting workshops with persons with disabilities

This report is a guide on how to hold community engagement workshops in partnership with people with disabilities and Organisations of Persons with Disabilities (OPDs), in order to strengthen sexual and reproductive health programs.

Plan International (2017) Let Me Decide and Thrive: Global Discrimination and Exclusion of Women and Girls with Disabilities

This policy brief outlines findings of research into the violations of the sexual and reproductive rights of women and girls with disabilities around the world. It outlines key barriers that contribute to the violation of rights and good practices in inclusion that can be built on. The report demonstrates how sexual and reproductive health rights are linked to the experience of violence and lack of agency for many women with disabilities. It also includes recommendations to tackle the systematic exclusion of women and girls with disabilities to help ensure their sexual and reproductive health rights are realised.

Ledger L (2016) Access to maternal and newborn health services for women with disabilities in Timor-Leste

This report outlines findings of research conducted by CBM Australia and Ra’es Hadomi Timor Oan (a national Disabled People’s Organisation) to better understand the access of women with disabilities to family planning and maternal and newborn health (MNH) services in Timor-Leste. It documents the experiences of women with disabilities in accessing family planning and MNH services and the experiences of service providers in providing services to women with disabilities. Commissioned by the Australian Government’s Department of Foreign Affairs and Trade, the research also provides a range of recommendations to strengthen access to these services by women with disabilities. The report is also available in Tetun from CBM Australia.

World Health Organization (WHO) and United Nations Population Fund (UNFPA) (2009) Promoting sexual and reproductive health for persons with disabilities: WHO/UNFPA guidance note

This guidance note identifies the issues of sexual and reproductive health (SRH) for persons with disabilities and provides advice on specific considerations for SRH programming for different groups and in different settings. It sets out a detailed framework for action in five key areas (partnerships, awareness-raising, research etc) for ensuring inclusive SRH programs. This guidance note is useful for SRH experts and advocates at the policy-making level, as well as those engaged in health programming more broadly.

Humanity & Inclusion Source: Key list resources on disability and sexuality

This key list presents information on sexuality and reproductive health issues for persons with disabilities. The resources featured include information about the rights and needs of different impairment groups, inclusive access to sexual health services, as well as gender, pregnancy and parenting issues.

United Nations Population Fund (UNFPA) (2008) Mental, sexual and reproductive health

This is a short and informative document highlighting important links between mental health, sexual and reproductive health and gender-based violence. It provides a brief description of some of the strategies that can be implemented to integrate mental health into sexual and reproductive health programs. This document can be used as a reference document by organisations working on disability, mental health and SRH.

United Nations Population Fund (UNFPA) (2009) A situational analysis of the sexual and reproductive health of women with disabilities

This working paper is a literature review of research on the issues related to SRH and women with disabilities in order to advise countries on policy and programming. It identifies the barriers to SRH services related to invisibility, lack of right to information, discrimination and gender based violence, and analyses the SRH needs within emergency situations. The paper also discusses the role of stakeholders such as international community, government, media and civil society. It identifies action points for identified challenges. This paper is useful for development organisations and policy makers at national and community level to identify the barriers to SRH services for women with disabilities and strategies to addressing them.

Humanity & Inclusion Source: Key list resources on maternal, newborn, child and reproductive health

This key lists present information on inclusive maternal, newborn, child and reproductive health interventions. The resources featured include information about early detection and intervention, access for women with disabilities to mainstream reproductive health services, including family planning, preconception care, ante- and postnatal care, safe childbirth, emergency obstetric care and HIV / AIDS related services; prevention, care and rehabilitation of women with obstetric fistula; and prevention, care and support for women surviving sexual violence.

World Health Organization (WHO) and United Nations Population Fund (UNFPA) (2010) Measuring sexual health: conceptual and practical considerations and related indicators

This document is an annex to the WHO and UNFPA report on the National-level monitoring of the achievement of universal access to reproductive health- Conceptual and practical considerations and related indicators. This annex lists indicators to measure health status, access to and use of services, outcomes, and policy and social factors were proposed in this document. These indicators can be used by policy makers and donors working in the areas of sexual health and healthy sexuality, sexual violence and female genital mutilation. Data obtained on these indicators can be disaggregated by disability to measure sexual health and access to services in that group.

WHO and UNFPA (2008) National-level monitoring of the achievement of universal access to reproductive health. Conceptual and practical considerations and related indicators

This document outlines a detailed framework of indicators to monitor the achievement of universal access to SRH; recommendations to implement the framework in country programs; and recommendations on possible indicators to measure access through linkages between SRH and HIV prevention, care and treatment. Although it does not provide indicators to measure inclusion of persons with disabilities in SRH programs, data disaggregated by disability on the proposed indicators at national level can provide information on the access to SRH for persons with disabilities. This document can be used by policy makers and disability-related organisations working on SRH programs.

Women with Disabilities Australia, Human Rights Watch, the Open Society Foundations and the Internat Global Campaign to Stop Torture in Health Care: Sterilisation of Women and Girls with Disabilities: A Briefing Paper

This briefing paper gives a background to the issue of forced sterilisation, outlines various international human rights standards that prohibit forced sterilisation, and offers several recommendations for improving laws, policies, and professional guidelines governing sterilisation practices. This document is a useful resource for policy makers and organisations working on SRH and rights of persons with disabilities.

Frohmader C and Ortoleva S (2013) The sexual and reproductive rights of women and girls with disabilities

This briefing paper examines challenges related to violation of sexual and reproductive rights of women and girls with disabilities and provides an analysis of human rights accountability comprising three elements: responsibility, answerability and enforceability. This paper also recommends key considerations for ensuring the future development agenda post 2015 is inclusive of, and responsive to, women and girls with disabilities. This paper is useful for the United Nations and other development agencies working on issues related to SRH for women and girls, and those working for the progress of and advancing the development agenda beyond 2015.

Spratt J (2013) A Deeper Silence: The Unheard Experiences of Women with Disabilities – Sexual and Reproductive Health and Violence against Women in Kiribati, Solomon Islands and Tonga

This document is a situation analyses on the SRH needs and rights of women with disabilities in Kiribati, Solomon Islands and Tonga. The situation analyses were based on literature review and interviewing stakeholders, service providers and women with disabilities in each country. Each country’s situation analysis is presented in separate sections that include analyses of policy, legal and service provision context in relation to SRH needs of women with disabilities, and experiences of women with disabilities. Recommendations for UNFPA and donors were provided at regional and country levels. This document will be useful for development agencies, donors and disability and/or SRH organisations working for the rights of women with disabilities.

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UNFPA (2020) We Decide - Key Messages for The Path to Equality for Women and Young Persons With Disabilities

This resource describes the necessary policy changes and investments needed for women and young persons with disabilities to fully realize their sexual and reproductive health and rights and be protected from gender-based violence.

Picture of mothers with their babies from Peru participating in a parent education class.

Photo: Thomas Einberger, 2002

Women participate in a parent education class in Peru. Copyright: CBM/argum/Einberger