Health is a fundamental human right that is linked to the realization of other human rights including the right to food, housing, work, education, human dignity, life, non-discrimination, equality among other. Persons With Disabilities (PWDs) face various challenges to the enjoyment of their right to health, often they have difficulties accessing health care in rural areas, slums and suburban settings, and for Women With Disabilities (WWDs) accessing and receiving gender sensitive health care services remains a very big challenge. The facilities in the labour suits are not friendly to WWD, there are no adjustable labour beds and if one hesitates getting up the high beds provided, the midwives will ask how “they climbed the bed to have sex and conceive”. Because of lack of interpreters in labor wards, mothers with a hearing impairment have lost their babies during delivery since they cannot effectively communicate with the midwives.
Against this background the National Union of Disabled Persons of Uganda (NUDIPU) an indigenous umbrella Non-Governmental Organization (NGO) of PWDs organized a meeting at Hotel Africana with the aim of influencing policy makers to address maternal health needs of WWDs. NUDIPU is advocating for Maternal New born Child Health (MNCH) and HIV integration into programmes and projects with the goal of reducing HIV related mortality and improvement of health outcomes for HIV positive mothers with disabilities at district and national level. MNCH programmes focus on improving the quality and availability of all maternal, newborn and child health services such as; antenatal and postnatal care, safer deliveries, care for newborn and young children, improved nutrition, routine immunization and effective Primary Health Care.
To a great extent, WWDs have been denied information and services about MNCH, sexual reproductive health and HIV/AIDS because most of the time the attitude of the health workers is negative towards them and they do not attend to them. Furthermore they have often been denied the right to establish meaningful sexual relationships and to decide whether, when and with whom to have a family. Many have been subjected to abandonment, forced abortions or forced marriages. WWDs are more likely to experience physical, emotional and sexual abuse and other forms for gender based violence. They are also more likely to become infected with HIV and other STIs.
WWDs suffer injustices and discrimination for instance the modes of transport don’t favor them, wheelchair users are almost completely excluded from most public transport. Also the design of buses and taxis present major obstacles to their use by WWDs such as; lack of sufficient grab rails at entrances and narrow aisles and seat spacing, hindering maneuvering inside vehicles. Cost issues appear to be one of the most important barriers to greater mobility, both in terms of accessing and maintaining mobility devices, and in terms of affording to travel by public transport. WWDs also find difficulty accessing the health centre facilities since they cannot climb stairs with wheelchairs, therefore, they are limited in accessing maternal care.
Medical practitioners sometimes treat WWDs as objects of treatment rather than rights holders and do not always seek their free and informal consent when it comes to treatment. Poor hygiene in public places for example in hospital has left women especially WWDs susceptible to several infections which end up affecting their health more. Lack of education is yet another root cause that has continued to compound the issue of maternal and child mortality.
The government of Uganda is urged to address maternal health challenges affecting WWDs through; providing access to health care on an equal basis and putting into consideration WWDs through equipping labor wards with adjustable beds, sign language interpreters in health centers at all levels and maintain proper sanitation. The government is also urged to provide health services and centers as close as possible to communities, including rural areas and provide motivated medical personnel in those centers. Also health caravans that can take services close to the community where WWDs are living should be put up.
WWDs need to be informed and have access to safe, effective, affordable and acceptable methods of family planning of their choice and the right of access to appropriate health care services that will enable them to go safely through pregnancy and childbirth.
In conclusion, the main rights holders in Uganda for maternal health and child health are the women, girls and the children, with poor women including WWDs being the most affected by poor maternal health care. The rights holders are lacking empowerment to claim their right to quality maternal health services. They also lack knowledge on good maternal health practices and on their rights to be protected from harmful practices. There is concrete need for laying the foundation for disability needs and access to quality MNCH, sexual reproductive health and HIV prevention services.
“Overview of MNCH, SRH, HIV/AIDS needs of PWDs” Penninah Mugume
“Maternal Health as a Human Rights issue in relation to WWDs” Nakibuuka Noor Musisi