Written by: CHIMODO ONYINYE LOIS

 

Young people have unique health challenges and needs as a result of their level of development and societal situations. Africa is characterized by a high population of youths with huge implications for sexual and reproductive health. However, for a differently abled youth, there is need to place the global spotlight on their sexual and reproductive health.

According to WHO, 2014 ‘differently abled is a person who has impairment that produces functional limitations, restrictions in activities or has social handicap’. To be differently abled reflects an interaction between the features of the person’s body and the features of that society in which the person live. Youths with impairment or a disability that limits or prevents the fulfillment of a role that is normal (depending on age, sex, and social and cultural factors) for that individual and impairment is any loss or abnormality of psychological, physiological or anatomical structure or function (Chhabra, 2016)., like vision Impairment, deaf or hard of hearing, mental health conditions, intellectual disability, acquired brain injury, autism spectrum disorder, physical disability.

These persons are always seen as being restricted in performing daily activities because of a complex set of interrelating factors, some pertaining to the person and some to the environment and social/political arrangements; like birth defects due to chromosomal abnormalities, poor antenatal care during pregnancy, quack delivery care, lack of immunization, lack of genetic counselling for couples prior to marriage, domestic violence, accidents, terrorism and war.

Hence, there is need to create a space to improve the sexual and reproductive health for the differently abled youths, as it goes a long way to protect the future and improve on existing situations.

 

SEXUAL AND REPRODUCTIVE HEALTH OF THE DIFFERENTLY ABLED YOUTHS

The role of the sexual and reproductive health in the management of the differently abled youths can be effected at the various levels of health care delivery;

1. Promotion and Preventive level
2. Curative level
3. Rehabilitation level

 

PROMOTION AND PREVENTIVE LEVEL

1. Health education of couples and young women on the care of self and proper planning of conception, pregnancy, birth preparedness and child care, early antenatal registration, compliance to ultrasound check regimen. Discourage negative health habits during pregnancy e.g. smoking, heavy drinking of alcohol, poor diet and food misconceptions, drug abuse and late antenatal registration. Hence, need to involve men during antenatal visit, as they have a role to play in family health decision making.
2. Advocate for equipping and proper training of health providers especially midwives on precautions during delivery to avoid abnormalities as a result of inefficient delivery of care.
3. Ensuring proper immunization of children, through community mobilization encourage women for proper compliance to regimen and also ensure delivery of potent vaccine through efficient cold chain system.
4. Educating women and health providers on the importance of routine drugs during pregnancy especially folic acid supplement, exclusive breastfeeding and growth monitoring of children for early detection of abnormalities.
5. Advocating for delivery of babies in equipped facilities for timely emergency response when required.
6. If any abnormality is detected, early management and referral should be facilitated.
7. Advocate for and carry out genetic counselling for young people and couples before marriage through thorough history taking to discover traits and obvious indicators that may lead to birth of children with disability. E.g. couple with history of genetic hearing loss from both family would need thorough counselling for informed decision to be made.

 

CURATIVE LEVEL

1. Have shown that differently abled persons have less access to healthcare services and therefore experience unmet health care needs. However, improvement of services/structures can enhance access to health care facilities that are friendly to different forms of disability. E.g. pathway and entrance for wheel chair, sign language experts in the hospital, braille for the blind, special call line and ambulance services etc.
2. Early referral to correct specialties required once any anomaly is detected. E.g. opticians, ororhinolaryngologist, ophthalmologist, physiotherapist, orthopaedic, psychologist, speech therapist, etc.
3. Early response and management of detected abnormalities can reduce the degree to which such condition whether curable or not, can affect the quality of life.
4. Through workshops and seminars to health providers, all negative attitudes of personnels and environmental factors that limit their access to health facilities can be eliminated.
5. Carry out researches to find ways to reduce the burden of the differently abled people as regards their reproductive life and responsibilities. e.g. Support during pregnancy, delivery assistance and child care aids.
6. Advocacy for training of specialists of various types of disabilities to enhance effective communication between the clients and care providers to ensure efficient and effective care is given.
7. Health education of adolescents and adults with disabilities on sex education, drug compliance, discourage health risk behaviour like alcoholism, negligence of clinic appointments, physical inactivity, smoking etc.
8. Advocate for reduction of cost of care for the differently abled people since most of them are not employed and therefore not entitled to National Health Insurance Scheme (NHIS) program.

 

REHABILITATION

1. Facilitate the uptake of prosthesis in conditions where required e.g. hearing aids, crutches, artificial eyes, legs, academic reliefs, etc.
2. Offer individualized psychological support and suggest coping mechanism to victims e.g. recreational activities, hobbies, like handball, playing musical instruments, drawing, writing, etc. and other occupational therapy.
3. Introduce them to group therapy, support groups to enhance early adaptation of victims to condition and independence strategies. E.g. training in special schools, supportive Non-Governmental Organizations etc.
4. Teach them their rights to attain the highest standard of life and healthcare services without discrimination.
5. Educate the public against all forms of discrimination and social stigma hued on differently abled people.

 

RECOMMENDATIONS

FOR THE HEALTH, EDUCATIONAL/PROFESSIONAL BODIES:

1. Proper training of health providers especially midwives on precautions to be taken during pregnancy, delivery and post-delivery care to avoid abnormalities as a result of inefficient delivery of care.
2. Proper training of health providers on Preventive healthcare services e.g. health education, thorough history taking and genetic counselling, maintenance of the Cold chain system i.e. a fridge system that maintains the potency of vaccines for immunization.
3. Addition and modification of educational curriculum to accommodate the training on the care of the differently abled people and special means/techniques of communication with them.

 

FOR THE GOVERNMENT:

1. Build more special schools for different types of disabilities, equipped with adequately trained staff and facilities to enhance learning.
2. Subsidize or offer free healthcare services for the disabled and structure hospital settings to suit their needs and comfort e.g. entrance for wheels chairs, guide for the blind, signs for instructing the deaf and dumb etc.
3. Create job opportunities suitable for different types of disabilities in which they can express their abilities and make income for a living.
4. Enforce employment of specialist e.g. sign language experts, special care psychologist (for different types of disabilities) in all sectors to enhance access for all differently abled people.
5. Mandate men to attend antenatal visits with their wives.

 

FOR THE DIFFERENTLY ABLED PEOPLE ASSOCIATION:

1. The needs of the differently abled people is better expressed by its members, therefore we suggest need to form strong association that equip members of their rights as humans first, then as regards their needs including health.
2. Request from Government the implementation of their rights in the society against all forms of discrimination and punishment for defaulters which will serve as deterrent to all.
3. Work with available Governmental and Non-Governmental Organizations and monitor the welfare of its members.
4. Also encourage members to be part of a support group and occupational therapy, and see ability in themselves; and avoid being part or being used in any form of crime or violence.  
5. Encourage members also to seek counselling for relationship and marriage in order to secure the future of their offspring. E.g. genetic counselling¸ family life education, family planning, child care and support etc.
6. Be informed of opportunities and expose members to opportunities that will improve their lives and give training e.g. Paralympics, scholarships, suitable job opportunities, tours, vocational/skill acquisition.

Youths with disabilities need health care and health programs for the same reasons any other youth does – to stay well, active, and be part of the community. Everyone has a role to play as regards their well-being, including health. Africa can give them a safe space.

 

REFERENCES

Austrarian National University, (2017).  Different types of Disabilities. Retrieved from https://services.anu.edu.au/human-resources/respect-inclusion/different-types-of-disabilities. Accessed on 16/12/2017

Centers for Disease Control and Prevention (CDC), (2017). Disability and Health. Retrieved from https://www.cdc.gov/ncbddd/disabilityandhealth/people.html .  Accessed on 13/12/2017

Chhabra S (2016) Differently Abled People and Their Life. Global J Med Clin Case Reports 3(1): 001-004. DOI: 10.17352/2455-5282.000022

Disabled world towards tomorrow (2017). Disability: Definition, Types and Models. Retrieved from https://www.disabled-world.com/disability/types/. Accessed on 16/12/2017

Healthy people 2020, (2017). Disability and Health. Office of Disease Prevention and Promotion. Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/disability-and-health. Accessed on 17/12/2017.

Krahn G.K., Walker D.K., EdD and Correa-De-Araujo R. (2015). Persons With Disabilities as an Unrecognized Health Disparity Population. Am J Public Health. 105(Suppl 2): S198–S206. doi:  10.2105/AJPH.2014.302182. PMCID: PMC4355692

The Association of People with Disability. Iam Differently Abled, not Disabled.  Retrieved from http://www.apd-india.org/blog/i-am-differently-abled-not-disabled-0. Accessed on 16/12/2017

WHO Factsheet (2017). Disability and health. Retrieved from http://www.who.int/mediacentre/factsheets/fs352/en/.  Accessed on 13/12/2017

World Health Organization (2014) Visual impairment and blindness. Fact Sheet N°282. Geneva, WHO.

World Health Organization (WHO), Commission on Determinants of Health. Closing the gap in a generation: Health equity through action on the determinants of health. Final report. Geneva, Switzerland: WHO; 2008.