The right to sexual and reproductive health : a scoping review of the experiences of persons with disabilities in South Africa

Abstract

The 2030 Sustainable Development Agenda and its 17 Sustainable Development Goals promise to uphold the principle of inclusivity by ensuring that no one, including persons with disabilities, is left behind. However, societal and cultural beliefs have created stigmas and biases about persons with disabilities' sexuality and sexual and reproductive health, affecting their ability to realise their sexual and reproductive health and rights, which includes access to services, comprehensive sexuality education, and autonomy to make informed decisions. Sexual and reproductive health and rights policies and programmes overlook the needs of persons with disabilities in South Africa. Using the Arksey and O'Malley framework, a scoping review was conducted to explore the experiences of persons with disabilities as they access sexual and reproductive health services in public healthcare facilities in South Africa. The scoping review has shown that persons with disabilities experience structural, system and rights explicit barriers to accessing sexual and reproductive health services at public health facilities in South Africa. Structural and system barriers include the lack of trained healthcare providers in sign language, the unavailability of sign language interpreters, geographic constraints of health facilities, disability unfriendly infrastructure, and lack of adaptable equipment. The rights explicit barriers include stigma and discrimination, deprivation of sexual and reproductive health information, lack of respect for agency and autonomy. The inadequacy of disability-friendly infrastructure and accessible equipment underscores the failure to meet the reasonable accommodation and universal design requirements established by the Convention on the Rights of Persons with Disabilities, thereby hindering the promotion of disability inclusiveness in healthcare facilities that provide sexual and reproductive health services. This failure to address sexual and reproductive health and rights creates barriers to access. This study demonstrates that realising the right to sexual and reproductive health is intricately linked to the experience of accessing sexual and reproductive health services.