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World Contraception Day: Stepping Outside the Box

By: Wanzala E. Martin, Women Deliver 100 Young Leader from Uganda

This blog is part of a series, edited by Women Deliver, in partnership with Impatient Optimists, on youth perspectives to celebrate World Contraception Day. Share your thoughts in comments and join the conversation at #WCD2012.

I am from Uganda, a country that many consider one of the earliest and best success stories in reducing HIV in the world. Whether or not you agree with this assertion, one fact for sure is that Uganda has experienced substantial declines in HIV prevalence and incidence during the past decade, especially among adolescents. This reduction can largely be attributed to increased access to contraception coupled with better funding to the health sector.

Uganda is just one example of Africa’s success story on the reproductive health front. Challenges remain, but we must acknowledge some considerable strides have been made to reduce HIV prevalence among the youth and achieve the MDG targets by 2015.

However, there is an area where progress has stagnated and the reproductive health of young people needs greater attention.

Young people, below the age of 35, constitute close to 65% of the total African population. Africa has the highest number of disabled youth, with some countries having more than 20% of the population labeled as disabled. Disabled youth suffer most from socio-economic vulnerabilities such as lack of education and information, poverty, unemployment, HIV, and other issues. They are neglected and, as such, usually end up falling through the cracks of development programmes.

The same can be said of their access to contraception.

Sexual and reproductive health (SRH) is essential for every young person (disabled or not) to become well adjusted, responsible and productive members of society. Persons with disabilities are among the most marginalized groups when it comes to these services and they often face many barriers to care and information. Yet they have the same needs as everyone else. In fact, persons with disabilities may actually have greater needs for sexual and reproductive health education and care because they are more likely to experience abuse and exclusion. It cannot be up to governments alone – it should be all of our personal responsibilities to safeguard the fundamental rights of youth with disabilities in Africa.

There is a frequent assumption that persons with disabilities are not sexually active and therefore do not need SRH services. This is very unfortunate and disheartening. Reports from the World Bank and UNFPA show that persons with disabilities are as sexually active as persons without disabilities. More often than not, however, their sexuality has been ignored (by governments and civil society alike) and their reproductive rights denied.

At best, policies and programmes have concentrated on the prevention of pregnancy but ignored the fact that many persons with disabilities will eventually have children of their own. At worst, forced sterilization and forced abortion often have been imposed on persons with disabilities. Furthermore, SRH services are often inaccessible to persons with disabilities because of physical barriers, the lack of disability-related clinical services, and stigma and discrimination.

Data from a 2009 report by the WHO shows that persons with disabilities face serious challenges to accessing SRH services not because they have a disability, but instead because of a lack of social attention, legal protection, understanding and support. Persons with disabilities often cannot obtain even the most basic information about SRH, let alone information about their rights to define what they do and do not want. They may have little experience relating to and negotiating with potential partners, they may be denied the right to establish relationships, or they may be forced into unwanted marriages where they may be treated more as housekeepers or objects of abuse than as a member of the family.

As a group, persons with disabilities fit the common pattern of structural risks for HIV/AIDS and other sexually transmitted infections – high rates of poverty, high rates of illiteracy, lack of access to health resources, and lack of power when negotiating safer sex.

It is not unusual for governments and policy makers across Africa to suggest that non-disabled persons should be the first to receive time, energy and resources. They suggest that disabled populations will receive attention as soon as the problems with the non-disabled population are solved. But this is unacceptable!

The lives of individuals with disability are no less valuable than the lives of those who are not disabled – there is no reason why the millions who live with a disability should delay or deny their needs and wait for an unspecified point in the future.

The health of youth with disabilities is a human rights issue and is a fundamental pillar for progress on Africa’s road to achieving the Millennium Development Goals by 2015.

Wanzala is a trained social worker with considerable experience in youth development practice who is passionate about gender, human rights and reproductive health issues for youth. He is a co-founder and Team Leader at Allied Youth Initiative – Uganda; youth-led organization headquartered in Mbale (Eastern Uganda) which promotes youth innovation for positive change. He is a member of Africa Youth Deliver on SRHR; the Women Deliver 100 Young Leaders 2013 and the African Youth Decade Alliance (AYDA). He also co-founded African Youth Development Link. He previously worked at Youth for Human Rights International and Youth plus Policy Network Uganda.

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