Ensuring Accessibility and Disability Inclusion in Sexual and Reproductive Health Services and Rights

ECDD will address barriers in accessing health care services and SRHR information and knowledge by enhancing the MINCH platform, a zero-cost digital platform which uses Interactive Voice Response (IVR) technology to deliver voice-based sexual and reproductive health and rights (SRHR)-related information to persons with disabilities in various parts of Ethiopia, rural or urban.

To ensure that the enhancements made to the MINCH platform are inclusive, ECDD will regularly engage with persons with disabilities, their parents and caregivers, organizations working with persons with disabilities, youth associations and community-based organizations at various stages of program design, project implementation, and monitoring and evaluation. Gaps in the current provision of SRHR information and knowledge will also be identified through feedback from the above-mentioned stakeholders and will be used as input for designing an appropriate technological solution.

Persons with disabilities are twice as likely to find health care provider skills and equipment inadequate to meet their needs and three times as likely to be denied care. The sexual and reproductive health (SRH) needs of those with disabilities continue to be de-prioritized in health systems. They often face barriers to care, services, education, and information about SRH, gender-based violence etc. Most governmental and non-governmental service providers have limited access to disability-specific information. Further, there is a critical gap in providing information and communication materials in an accessible format by health providers (e.g., lack of materials in Braille, large print, accessible language, and pictures; lack of sign language interpreters).

Bodily autonomy and a right to safe and accessible health care are integral to justice and equity. Those most effected by the anti-abortion movement in Ethiopia are the most vulnerable in society, and therefore, maintaining and working towards destigmatized, safe, and accessible reproductive health care is critical. Through this project EngenderHealth will adapt and apply strategies and tools from other programs, build its own capacity for countering opposition to abortion and beyond, and provide lessons and inspiration to others who are working toward just and equitable societies.

Despite positive trends in RH outcomes across Ethiopia, unsafe abortions remain a reality, particularly among rural women, poor urban women, and young women and adolescent girls. In this latter group, data from 2014 estimated that one-third of abortions were clandestine. The legal framework for abortion leaves room for professionals’ individual interpretation and discretion concerning whether criteria for abortion are met or not. Two recent studies on health professionals’ attitudes towards abortion describes their struggle to balance religiously- and morally-based opposition to abortion against their professional duty to provide abortions and their concern for the women, and a national survey of physicians working in Ethiopian public hospitals showed that the respondents often experienced dilemmas related to reproductive health issues. Ongoing anti-choice groups’ campaigns also target health professional schools, Ethiopian health journals, and media and churches. Such campaigns, in most cases, are led by religious-affiliated medical professionals.