Fifteen percent of the world’s population has some form of disability, the most common form being a physical disability. Ten percent of women with disabilities are of childbearing age, but disabled women’s access to maternity care is limited. Women with disabilities experience problems during pregnancy and childbirth due to physical barriers, barriers to information, communications challenges and the attitude of providers.
In Zambia, International Confederation of Midwives (ICM) member association (MA) the Midwives’ Association of Zambia (MAZ) is ahead of the curve in providing equal, high-quality care to women and other birthing people with disabilities.
In partnership with United Nations Population Fund (UNFPA), MAZ has introduced sign language training to its member midwives to ensure provision of health services for young people living with hearing impairment, so they may access information on sexual and reproductive health. Zambian Minister of Health, Sylvia Masebo says this initiative is part of national efforts to increase access to sexual and reproductive health services and information for young people.
“We are also translating selected information, education and communication materials into sign language and Braille, which will soon be distributed to the Deaf communities and around health facilities,” said Ms. Masebo in an interview with Lusaka Times. “We also have plans as a ministry to build ramps in all health facilities to enhance accessibility by people with physical disabilities.”
Royda Matipa, a Zambian registered nurse and midwife, participated in the week-long sign language training, and she says she has already managed to improve midwifery services for hearing-impaired women in Zambia.
She recalls her interactions with one young woman, who due to her disability, had never been educated on any aspect of her own sexual and reproductive health and safety.
“I took the opportunity to talk with her in sign language about gender-based violence,” said Royda. “She was in grade nine. She was just a girl, and she was therefore vulnerable to gender-based violence.”
Royda explained that disabled women in Zambia are exceptionally vulnerable to violence, unplanned pregnancy and sexually transmitted infections (STIs), due to their lack of access to information. When one is unable to receive information and/or communicate, they can easily be taken advantage of, she says.
“At the end of our session, the girl said in sign language that she was so grateful to have been able to speak with a midwife,” said Royda. “It was the first time anyone had explained health and safety matters to her. She said she finally felt closeness.”
The need for provision of this essential information is continuous, Royda says. While there are adolescent-focused education programmes in Zambia, disabled women don’t have equal access to these programmes. That’s why she says all healthcare providers should be trained in sign language.
“This is my job; I am a midwife. I can still change the image of midwifery. These women, they are vulnerable, because they are not able to get information.”
Zambian midwife, MAZ member and ICM Young Midwife Leader (YML) Phillip Chirwa agreed that midwives must receive more training in care for disabled people, but he also noted that collaboration with other healthcare providers is critical in order to achieve true inclusive, equitable care.
“It’s simple,” said Phillip. “Those who are physically or cognitively disabled can also have children, so the most important thing is to provide equal care to all. We need to incorporate midwifery and mental health by collaborating with mental health professionals, so we can provide great care to every person as a team.”