Disparities in Accessing Sexual and Reproductive Health Services at the Intersection of Disability and Female Adolescence in Tanzania

Int J Environ Res Public Health. 2021 Feb 9;18(4):1657. doi: 10.3390/ijerph18041657.

Abstract

Despite at times having greater needs for sexual and reproductive health (SRH) services, adolescents with disabilities often face challenges when trying to access them. This inaccessibility is further exacerbated during female adolescence. The qualitative study examines how SRH services respond to the characteristics of Tanzanian adolescent females with disabilities. We used the method of empathy-based stories to investigate the perceptions of 136 adolescent females with disabilities of their access to SRH services in Tanzania. The study used thematic content analysis and the Levesque model of health care access was applied as an analytical framework. The results demonstrate that discrimination affects access at different phases of care-seeking, that affectionate behaviour of providers is a central enabler of access, and that for this population access relies on a collective effort. We propose that affection, as an enabler of access, is as an additional provider dimension of access to SRH services for adolescents with disabilities, serving as a "reasonable accommodation" to the health care systems in southern contexts and beyond.

Keywords: SRHR; Tanzania; access to health care; adolescence; disability; inequality; sexual and reproductive health services.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Disabled Persons*
  • Female
  • Health Services Accessibility
  • Humans
  • Reproductive Health
  • Reproductive Health Services*
  • Sexual Behavior
  • Tanzania