Challenges Faced by People with Disabilities in Accessing Contraception and Childbirth Care in Dar es Salaam, Tanzania

Abstract

Background People with disabilities (PWDs) experience significant challenges in accessing sexual and reproductive health (SRH) services. Consequently, global, regional, and national policies recommend equal rights for PWDs to access quality health care. Tanzania is working to improve SRH accessibility; however, women with disabilities still face numerous challenges in accessing reproductive and maternal healthcare services. These challenges must be understood and addressed for effective disability-inclusive SRH services.Objective This study explored the challenges faced by women with disabilities in accessing contraception and childbirth services in Tanzania.Methods This exploratory qualitative study involved nine focus group discussions with 61 healthcare professionals (HCPs) and in-depth interviews with 21 caretakers and 15 PWDs. We used purposive sampling to recruit HCPs from their respective health facilities. PWDs and caretakers were recruited through the community disability association and organization. Thematic analysis, as guided by Braun and Clarke (Citation2006), informed the data analysis.Results Findings indicated autonomy and consent challenges attributed to dependence on caregivers for health decisions, reliance on external support, and limited access to accurate information. Negative experiences due to societal stigma were linked to experiences of trauma, including accounts of physical and verbal abuse and societal judgmental attitudes about their ability to carry a pregnancy. The competence gap among HCPs contributed to their negative attitudes and low confidence in interacting with PWDs during care provision, undermining PWDs’ dignity. Lastly, systemic barriers related to communication, lack of supportive facilities, and unsuitable infrastructure were documented.Conclusion Women with disabilities face challenges in accessing contraception and childbirth services in Tanzania. These findings highlight the need to train HCPs to understand the unique needs of women with disabilities and to improve their clinical knowledge, attitudes, and skills in providing SRH care for PWDs.