The impact of SRHR restrictions on persons with disabilities
Women,
girls and gender diverse persons with disabilities face many obstacles
in the exercise of their sexual and reproductive health and rights. This
can be explained by the intersectionality of gender and disability
discriminations and by the very intention behind SRHR restrictions. In
many cases, policies restricting SRHR are used to control and “optimize”
the population towards a desired population outcome.
Based on stereotypes rather than lived realities, these policies have
a discriminatory impact. Among these stereotypes is the idea that while
women are expected to give birth, women with disabilities are seen as
incapable of parenting or making reasoned decisions on their sexual or
reproductive health (Women Enabled International et al.,
2025). Therefore, SRHR-restricting policies can result in forced
sterilizations, abortions or contraception, in the removal of children
from parents with disabilities, in de-prioritizing access to healthcare
for parents and children with disabilities, and in unnecessary or
non-consensual surgeries.
Access to SRH information and services for persons with disabilities
Even
when available, SRH information and services are not always disability
accessible or inclusive. This can be explained by the forementioned
stereotypes on persons with disabilities and their expression in
political decision-making.
The results of a Handicap
International (HI) research in 2021 on access to SRHR information and
services in Uganda and Bangladesh, underline persons with disabilities’
dependency on the family, who plays a role as gatekeeper in promoting,
influencing or obstructing this access based on their perceptions,
misconceptions and cultural beliefs (Santos, ALR, et aI, 2021).
Regarding
inclusive healthcare services, HI’s 2023 research in Uganda and Rwanda
sheds light on the importance of disability-inclusive protocols,
trainings and access to healthcare facilities, as well as coordination
with organisations of persons with disabilities. Without it, women,
girls and gender diverse persons with disabilities are exposed to
misconceptions and lack of knowledge about their SRH rights (van der
Heijden, 2023).
Access to SRHR information and services for
persons with disabilities is particularly important as HI’s research
shows high prevalence of isolation and abuse (Santos, ALR, et aI,
2021) and disproportionate violations of their SRH rights (van der
Heijden, 2023). In the current context of multiple crises and the rise
of authoritarian and anti-SHRH groups, the collaboration between human
rights civil society organisations towards inclusive programming is
crucial.
As a matter of fact, barriers to access SRH services
and information are strengthened in situations of crisis, due to a
context of impunity, the scarcity of health products, the shutdown of
facilities and the difficulties to disseminate information. Situations
of crisis make women, girls and gender diverse persons with disabilities
more vulnerable and dependent on others (Berger, G., Aresu, A., and
Newnham, J., 2022). Moreover, emergency services are often not
accessible for persons with disabilities.
"Even when available, SRH information and services are not always disability accessible or inclusive. This can be explained by the forementioned stereotypes on persons with disabilities and their expression in political decision-making."
Chloé Sibille
A disability-inclusive approach to SRHR
HI strongly
advocates for a disability-inclusive approach to SRHR, taking into
consideration the discriminations and stereotypes related to disability.
Disability-inclusive SRH is grounded in a human rights-based approach,
under the principle that persons with disabilities can meaningfully
participate and have their SRH rights fulfilled. Beyond a
disease-oriented SRH, this approach encompasses a comprehensive
definition of SRHR including sexual and general well-being.
A
disability-inclusive approach to SRHR projects can be achieved through a
comprehensive implementation at various levels, including at an
individual level, delivering targeted support, but also at a structural
level, engaging with governments to implement inclusive policies and
trainings, and developing person-centred consensual care. As such,
organisations can use social and behaviour change communication to raise
community awareness (van der Heijden 2023).
Disability-inclusive SRHR projects in practice
Working
alongside persons with disabilities and their representative
organisations for more than 40 years, HI has developed an expertise in
implementing disability-inclusive SRHR projects.
A good example
of HI’s approach to disability-inclusive SRHR is its participation in
the WISH2ACTION programme. The latter was a multi-country initiative
from the International Planned Parenthood Federation (IPPF) in which HI
participated as a disability inclusion specialist.
Operating
between 2018 and 2024, the project aimed at ensuring that marginalized
and hard-to-reach populations have access to quality, integrated and
inclusive family planning and SRHR services. As part of this project,
Handicap International worked in 11 countries (Afghanistan, Bangladesh,
Ethiopia, Madagascar, Mozambique, Pakistan, Somalia, South Sudan, Sudan,
Tanzania and Uganda).
HI’s activities included:
- Assessing barriers at health facilities
- Improving accessibility based on those findings
- Delivering
capacity building and trainings to health workers, organisations of
persons with disabilities and government representatives
- Engaging
with organisations of persons with disabilities to support their
actions and collaborate in disseminating information and advocating for
disability-inclusive services at both community and facility levels
- Developing
policy and coordination mechanisms such as Disability Inclusive
Technical Working Group at governmental level, and Cluster Management
Committees (government representatives, social services, service
providers, and organisations of persons with disabilities) at the local
level, in Bangladesh
- Disseminating disability-inclusive information
- Improving Data Collection and Management, using the Washington Group Questionnaire (WGQ)
Thanks to the action and collaboration of various organisations, this
programme ended in 2024 with a positive outcome. Overall, around 4
million unsafe abortions were averted, more than 21’000 maternal deaths
were prevented, and 2’500 healthcare providers were trained in inclusive
SRH practices (Handicap International UK, 2025).
Since then,
international, national and local structures and civil society
organisations have continued their collaborative work toward inclusive
SRHR, with the common goal of alleviating the suffering caused by SRHR
violations, which remain far too numerous, too frequent and too
widespread across the globe.
References
Berger, G., Aresu, A., and Newnham, J. (2022) Sexual
and Reproductive Health and Rights for All: Disability Inclusion from
Theory to Practice, Women’s Integrated Sexual Health 2 Action Project
(WISH2ACTION). Handicap International, PG l 37, pp. 170. Available
at:
https://www.hi-us.org/sn_uploads/document/1288_HI_Guidelines_17_10_22_DIGITAL.pdf.
Handicap International UK (2025) WISH2ACTION. Available at: https://www.humanity-inclusion.org.uk/en/projects/wish (Accessed 24/11/2025).
Santos, ALR, et aI. (2021) Access
to Sexual and Reproductive Health and Rights Information and Services,
Perspective of women and girls with disabilities in Uganda and
Bangladesh. Handicap International, pp. 44. Available at: https://www.hi-us.org/sn_uploads/document/1257_HI_report_research_2022_P6_17_10_22_DIGITAL.pdf.
van der Heijden, I. (2023) Avoiding
Harm, Respecting Rights: Facilitating Person-centred,
Disability-inclusive Informed Consent in Sexual and Reproductive Health
Settings (Experience from Uganda & Rwanda). Lyon, Handicap International, Global Inclusive Health Division, RS n°19, pp. 54. Available at: https://www.hi-us.org/sn_uploads/document/Disability-inclusive-informed-consent-in-SRH-RS-19.pdf.
Women Enable International, et al. (2025) Joint
submission to the CRPD Committee’s Draft guidelines on addressing
multiple and intersectional forms of discrimination against women and
girls with disabilities, pp. 10.
