Bringing Light: Addressing the Sexual and Reproductive Health and Rights (SRHR) of People Living with Physical Disabilities (PWDPs)

Summary:

The aim of this project was to build the capacity of People Living with Physical Disabilities (PWPD) on their Sexual and Reproductive Health and Rights (SRHR). The project was also aimed at increasing awareness among the general public on the SRHR needs of PWPDs as they are generally considered asexual, hence not needing access to SRHR information and services. To achieve this, Aahung planned to build capacity of the caregivers, and trainers who work with/for people living with disabilities and develop user-friendly resource material to aid them to teach people living with physical disability about their SRH needs and rights which is an innovation within itself. The approaches discussed here, however, apply broadly to all aspects of health programming for people with physical disabilities. Aahung envisioned transforming these trainers into advocates for SRH needs and rights of PWPDs in their respective workspaces and/or communities and integrate the newly-designed SRHR-related resource material into their activities. The programme was effective in improving SRHR of PWPD and was appreciated by the participants as the holistic nature of the programme ensured that their needs are being understood and addressed.

Background/Objectives:

In Pakistan, there is a 'culture of silence' around disability and sexual and reproductive health (SRH) rights. Therefore, SRH needs and rights of people living with disabilities remain unaddressed because of prevailing cultural norm and traditions that stigmatize sexuality of people living with disability (PWD) and prevent them from claiming their sexual rights and taking control of their reproductive lives. Furthermore, people with disabilities are unable to access quality and tailored SRHR information and services.

Description of Intervention and/or Methods/Design:

Aahung developed user-friendly resource material and training modules for capacity building. For people with hearing impairments, animated videos were dubbed into sign language on SRHR issues including gender, puberty, sexual abuse, early age marriage, family planning, and abortion. The content was translated into braille for people with visual impairments and videos were dubbed into sign language for people with hearing impairments. Interpreters were also part of the training. 19 Master Trainers were trained on the SRHR needs of PWPDs. Participants included trainers working in relevant organizations, care givers, and PWPDs. Training facilitators also included PWPDs to improve communication with participants. Trained participants reached out to approximately 200 people, sensitizing them on the SRHR needs of PWPDs. To assess the effectiveness of the intervention, pre- and post-test were conducted. The questionnaire was developed in English and was translated to Urdu and Pakistan Sign Language for the hearing-impaired participants.

Results/Lessons Learned:

There was a substantial increase in the knowledge of participants post-training. At pre-test, 55% participants were able to identify the differences between sex and gender, however, at post-test, all participants were able to identify the differences. Knowledge related to girl's puberty was 0% before the training and increased to 64% afterwards. Similarly, knowledge about boy's puberty was 1% and increased to 73% after the training. 54% of the participants believed that ejaculation causes weakness and infertility whereas after the training no participant agreed with this. Moreover, 82% caregivers reported that they have insufficient information to address SRHR needs of people with disabilities, however, post-training, 91% of the participants believed that they had sufficient information. SRHR is not something that is spoken about in the disabled community (hearing and visually impaired), therefore this training was an opportunity to learn something new and share with others.

Discussion/Implications for the Field:

Participants felt that the videos/activities were an effective way to understand and apply the knowledge learned, however, interactive activities were more useful than those involving writing, because for those with physical disabilities, discussions were easier and a more effective way of learning than writing their responses. Furthermore, interactive and userfriendly resource materials designed for specific disabilities play a vital role in sensitizing PWPDs on SRHR subjects generally considered to be taboos. Since PWPDs are reluctant to reach out to service providers for fear of being mocked, these interactive materials are an effective strategy to address their SRHR-related misconceptions.

Abstract submitted by:

Naureen Lalani - Aahung
Sheena Hadi - Aahung
Aisha Ijaz - Aahung
Junaid-ur-Rehman Siddiqui - Aahung