Intersecting Sexual and Reproductive Health and Disability in Humanitarian Settings: Risks, Needs, and Capacities of Refugees with Disabilities in Kenya, Nepal, and Uganda

Abstract

The current literature recognizes the fact that persons with disabilities have historically been deprived of their sexual and reproductive health (SRH) rights. Little is known, however, about the situation for women, men, and adolescents with disabilities in humanitarian settings. The Women's Refugee Commission led a participatory research project with partners to explore the risks, needs, and barriers for refugees with disabilities to access SRH services, and the practical ways in which these challenges could be addressed. The study gathered information from refugee women, men, and adolescents aged 15-19 with physical, intellectual, sensory, and mental impairments in refugee settings in Kenya, Nepal, and Uganda. Findings showed that refugees with disabilities demonstrated varying degrees of awareness around SRH, especially regarding the reproductive anatomy, family planning, and sexually transmitted infections. Among barriers to accessing services, lack of respect by providers was reported as the most hurtful. Pregnant women with disabilities were often discriminated against by providers and scolded by caregivers for becoming pregnant and bearing children; marital status was a large factor that determined if a pregnancy was accepted. Risks of sexual violence prevailed across sites, especially for persons with intellectual impairments. The ability of women with disabilities to exercise their SRH rights was mixed. Refugees with disabilities showed a mixed understanding of their own rights in relationships and in the pursuit of opportunities. Findings speak to the need to realize the SRH rights of refugees with disabilities and build their longer-term SRH capacities.

Keywords: Disability; Humanitarian settings; Kenya; Nepal; Refugees; Sexual and reproductive health; Uganda.