Access of women with disabilities to MNH Services pdf

 Access to maternal and newborn health services for women with disabilities in Timor-Leste

August 2016

CBM-Nossal Partnership for Disability Inclusive Development &

Ra'es Hadomi Timor Oan

In many contexts, women with disabilities experience more barriers to health information and services, including maternal and newborn health (MNH) services, when compared to women without disabilities. The United Nations Population Fund (UNFPA) has argued that people with disabilities are a "significant constituency with neglected needs" in relation to sexual and reproductive health (SRH) care. Furthermore, various studies have reported current maternity services present women with disabilities "with structural barriers, poor labour and birth facilities and lack of access to appropriate services" and that this "appears to be widespread throughout current maternity services across different countries".

In Timor-Leste, disabled people's organisations have highlighted some of the specific challenges that women and girls with disabilities face in accessing health care, and SRH services in particular, such as "[mistaken] assumptions that people with disability are not sexually active". Civil society organisations in Timor-Leste have also argued that current frameworks relating to the rights of women require increased attention to "the specific multiple and intersectional discrimination women with disabilities face". Additionally, the Ministry of Health's Reproductive, Maternal, Newborn, Child and Adolescent Health Strategy 2015 - 2019 highlights the need for research in various aspects of MNH to support "strategic decision making for improving services". It is hoped the present study will contribute to more informed and strategic decision making by improving understanding of the factors which influence access to MNH services for women with disabilities.

In this context, to support disability inclusion within the health systems of Timor-Leste, the Australian Government’s Department of Foreign Affairs and Trade commissioned research to better understand the access of women with disabilities to family planning and maternal and newborn health (MNH) services, including antenatal care (ANC), delivery and postnatal care (PNC). The research was also commissioned to explore the experience of service providers in delivering services to newborns with impairments.

This report explores the perspectives of midwives and doctors (service providers) and women with disabilities in terms of access to services. Research participants' understanding of disability and the MNH needs and rights of women with disability are presented as well as the reported access to different services in the continuum of care. The influence of barriers and enabling factors on the access of women with disabilities to family planning and MNH services is discussed. Additionally, the experience of service providers in providing services to newborns identified as having impairments during the postnatal period is documented. Importantly, this report provides recommendations developed from the findings to promote disability inclusion within family planning and MNH programs in Timor-Leste.