Sexual and reproductive health of women with disability in the Philippines: Building evidence for action

W-DARE aim and major research questions

Aim: to improve access to quality SRH programs for women with disability in the Philippines

• What are the experiences of women with disability in accessing SRH programs in Quezon City and Ligao City? How do these differ from women without disability?

• What are the SRH service and information needs and priorities of women with disability?

• What interventions are effective in improving access to quality SRH programs for women with disability?

Action research in partnership• Nossal Institute for Global Health, and Centre for

Health Equity (University of Melbourne)• Social Development Research Center (De La Salle

University)– WOWLEAP– PARE– Likhaan Center for Women’s Health– Center for Women’s Studies (University of the

Philippines)– UNFPA Philippines Country Office

Baseline picture – data sources• Household survey with 3051 adults (data

on prevalence, well-being and participation restrictions)

• Women with functional limitation (and matched controls) completed a SRH questionnaire (253 women in total)

• 37 in-depth interviews with women and girls with disability

• 8 focus group discussions (partners, parents, women without disability)

• 20 key in-depth interviews with SRH service providers

Top: Donna (CBR worker) collecting household survey data in LC; Below: Completed surveys ready for data entry and analysis

Early analysis

• Prevalence of functional limitation:–Quezon City is 7.15% (95% CI: 6.15, 8.29)– Ligao City is 14.04% (95% CI: 11.52, 17.00)

• Disability associated with increased age; lower levels of education; unemployment or economic dependence

Access to SRH servicesBarriers

• related to service providers (attitudes, behaviours, knowledge and skills, gender of SP)

• related to facilities (physical barriers, policies, assistive devices)

• related to women with disability (awareness of services, SRH knowledge, mental health, fear of services, self medication)

• economic barriers (cost of services, transport, SL interpreters)

• availability of services and supports (availability of local SRH services, transport, SL interpreters)

• related to gender norms (domestic responsibilities)

Women’s SRH compromised by• Abuse: Abuse is frequent and is perpetrated by

family members and partners, as well as strangers and possibly service providers

• Sexual, physical, verbal, and emotional abuse reported; also restriction of movement/opportunities and domestic exploitation

• Negative public attitudes towards women with disability: in public places, from health and transport service providers, from family members

• Some notable instances of solidarity and support

Clockwise from top L: Participants in Disability Inclusion workshop, QC; Pia collecting data during the household survey, QC; Weng with young people who are deaf in LC.

Enabling local environments

An enabling society in the Philippines

Demand side interventions

Supply side interventions