The South African Medical Research Council (SAMRC) recently hosted the first Forgotten Agenda Webinar which focused on the sexual reproductive health and rights (SRHR) of young women with disabilities – particularly during the COVID-19 pandemic.
Titled: “Including Young Women with Disabilities and their Sexual and Reproductive Health Rights (SRHR) during COVID-19 in South Africa: What do we know and where are the Gaps?”, this is the first installment in a series of the “Forgotten Agenda” webinars to follow. The webinar was attended by young women with disabilities, service providers, policy makers, development partners and researchers from various organisations, including the SAMRC.
Setting the tone for the webinar and explaining the SAMRC’s Forgotten Agenda Project, Dr Jill Hanass Hancock, a Senior Specialist Scientist within the Gender and Health Research Unit (GHRU), highlighted that young women with disabilities are part of a highly marginalized group – namely, people with disabilities who make up to at least 15% of the world’s population. According to Dr Hancock they are part of all key populations targeted by sexual and reproductive health programs and are among those living with HIV. “Hence without persons with disabilities ending inequalities and providing access to sexual and reproductive health services to all is impossible,” said Dr Hancock.
Citing the ‘Disability rights during the pandemic: A global report on findings of the COVID-19 Disability Rights Monitor’, which revealed the serious breakdown in provision of support for people with disabilities, who were without access to necessities, Dr Hancock said the SRH rights and needs of young women with disabilities were forgotten.
She also pointed out some of the critical findings from the recently launched UNFPA’s Report on Gender and Disability under the COVID pandemic – including that the barriers to accessing necessities including SRH information, exercising bodily autonomy for women and girls with disabilities have increased during the COVID-19 pandemic worldwide. At the same time, exposure to GBV increased while support mechanisms and access to services further declined.
In taking a more local perspective, Dr Hancock explains that the Forgotten Agenda project focuses on the next steps and seeks to understand the impact of the COVID-19 pandemic on the lives of young women with disabilities and their need for and access to SRHR commodities and services in KwaZulu-Natal. The project includes a longitudinal study with a cohort of young women with and without disabilities as well as strategic conversations with young women with disabilities themselves, researchers, government and community representatives.
“Through these engagements we will understand the experience of young women with disabilities better, but also be able to identify good practice and potential approaches to make services, interventions, and emergency response more inclusive,” she added.
SRHR needs and gaps, before and during the COVID-19 pandemic in South Africa
In her keynote address to the webinar, Ms. Thembi Zulu, the Deputy Director: Women’s Health, Sexual and Reproductive Health and Rights at the National Department of Health (NDoH) reflected on the needs and gaps, before and during the COVID-19 pandemic in South Africa. According to Ms. Zulu, COVID-19 and accompanying countrywide lockdown has deepened the layers of vulnerability and challenges for persons with disabilities, including young women with disabilities, and discontinuities in the health system. “Some COVID-19 regulations provided specific challenges to people with disabilities, for example how to practice social distancing when one needs hands for assistance,” said Ms. Zulu.
She also highlighted that due to multiple and intersecting forms of discrimination on the basis of gender and disability, women and girls with disabilities face unique and pervasive barriers to full realization of their SRHR. “Attention to the SRHR needs of persons with disabilities is important to ensure the protection and promotion of their human rights, to move forward the international development agenda, and to build a truly inclusive society,” Ms. Zulu told the participants.
Unplanned pregnancies as a SRHR challenge
On unplanned pregnancies as a SRHR challenge, Dr Anja Smith from Stellenbosch University’s Research on Socioeconomic Policy (RESEP) weighed in on the quality and reliability of contraception services.
While in 2017 the NDoH found that there was an overall low contraceptive use in SA of which 58% was of modern contraceptive methods among currently married and sexually active unmarried women, little was known about quality and reliability of contraception care in SA.
In attempts to find the answers, Dr Smith and colleague, Prof Ronelle Burger undertook two studies to investigate the quality of contraception advice and post-COVID decline in contraception.
Dr Smith told the webinar attendees that they found that not enough information about women seeking advice was available and that women were not allowed to make a choice between all options. “Contraception access also showed low resilience, and this is attributable to low prioritisation amongst users and too few distribution channels,” said Smith adding that the most vulnerable were hit the hardest and most likely to avoid clinics – especially due to fears.
Discussions and way forward
The two-hour-long webinar discussed why young women with disabilities are more vulnerable to adverse sexual and reproductive health and rights (SRHR) outcomes than their peers without disabilities. The diverse participants also tackled the concern over why this vulnerable group lacked access to SRHR services and commodities.
One participant, Inamandla Masinga, Founder & Director of Pink Roses, highlighted the need to provide access to people with different kinds of disabilities, but also to ensure that people with disabilities are represented in other spaces such as the women, youth or LGBTQI sectors.
Dudu Radebe, Managing Director of CREATE, another participant, said, “there is a need to continue with household support in order to identify people with disabilities in need and to develop strategies for women with disabilities to disclose violence in their homes.”
Sr Mbali Struman, Operational Manager at the Department of Health, also highlighted the lack of knowledge and skills among healthcare workers and the need to improve their skills to cater for persons with disabilities through sensitizations and focused training.
In the end, a sentiment echoed by all was that SRHR serves as an umbrella for a vast array of issues, including maternal health, abortions, menstrual health as well as HIV prevention and care.
Forgotten Agenda Webinar Recording (in English and SA Sign Language) | View