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Creating lasting change for women with disabilities in Kaduna state, Nigeria

Salome Luka Net, October 2024

One in five women has a disability, yet too often, women and girls with disabilities are neglected in sexual and reproductive health policies and programmes.

My name is Salome Luka Net, I’m a woman with a visual impairment and the executive director of Heart-to-Heart Inclusive Education Foundation. We are an organisation representing people with disabilities in Kaduna state in northern Nigeria, and have helped to co-create and deliver an innovative family planning project in Nigeria.

So that’s why, together with Sightsavers, I’m attending the Global Health Practitioners Conference in Nairobi, Kenya, on 28-31 October 2024. The family planning project is focused on improving access to sexual and reproductive health rights and services for women with disabilities, and we will be highlighting the importance of this during the conference.

Access to family planning for women with disabilities

Women with disabilities face so many societal and attitudinal barriers when accessing their sexual and reproductive health and rights.

In Kaduna state, women are answerable to their husbands and families. As an example, if a woman’s mother-in-law does not permit it, she cannot go to the hospital for her baby’s delivery, even if her husband says yes. This is because the culture does not permit women to disrespect their families.

Additionally, there’s a lot of wider discrimination in the way society treats people with disabilities. When health workers attend to us, they sometimes pass comments that they shouldn’t or will not attend to us the way they should. This attitude then discourages women with disabilities from visiting the hospital at all.

Then there are issues accessing health care facilities. Some structures are not accessible. As a visually impaired person, I cannot go to these places on my own. Even with an aide, it’s not easy for me.

Sightsavers at the Global Health Practitioners Conference

Join Salome and Sightsavers on Tuesday 29 October at 2pm-3.30pm East Africa Time (EAT), where we’ll be sharing insights on making sexual health programmes inclusive of women with disabilities.

Salome will also be speaking at a panel session on improving health equity for people with disabilities on Thursday 31 October at 11am-12.30pm EAT.

About the conference

Addressing barriers to improve access

The project has done a lot to address these barriers. So far, we’ve trained more than 1,500 health care workers on how to attend to people with disabilities. We have also been sensitising the community and people with disabilities on their right to health care.

My organisation was fully involved in the social behaviour change activities conducted in the communities, which raised awareness about sexual and reproductive health and rights, and changed community attitudes towards family planning. We hosted town hall meetings for traditional and religious leaders, created community dramas and held peer-to-peer sessions led by men and women facilitators who have disabilities themselves, where we sensitised other people with disabilities.

A group of smiling women in Nigeria hold posters and leaflets about family planning.
Sightsavers worked with women in Kaduna to develop family planning materials. © Sightsavers/Kazahzachat Solomon Kabantiok

For the design of the materials, we were involved from the co-creation stage, right through to implementation. These materials were then used during the social behaviour change workshops and peer-to-peer sessions where we explained to people with disabilities about their sexual and reproductive health and rights. The workshops were held for three groups: married women, single unmarried women and unmarried men with disabilities.

So many things came out in the workshops. For example, some people didn’t know they had access to family planning at all. Over the six months that the activities were held, some women went to the hospital and accessed family planning services before the end. Some of them didn’t like going and were shy. But because of the training that the service providers received, they treated the women with disabilities well and the women were given appropriate care.

Many of the unmarried men with disabilities we worked with didn’t know they could go to the hospital and get condoms free of charge. Now they also know that if they don’t use contraception, especially condoms, they risk getting sexually transmitted infections. There’s been a great improvement and every day we get positive feedback from them.

Accessibility in health care facilities has also improved. Some of the facilities now have ramps and there are a lot of ongoing changes. We have established good relationships with health care service providers – they still get back to us with questions, we do visits/checks and we talk to people with disabilities about their experiences.

Putting women with disabilities in the driving seat

This project was able to make an impact because the people involved were the people wearing the shoes. I used to know maybe one or two types of family planning, but now I know so many. I can even tell people about it because although I’m not a service provider, I can speak to them because of the knowledge and training I’ve received. I can train people on how to attend to people with disabilities too.

It was the best thing to have Nigeria’s national policy on sexual and reproductive health and rights for people with disabilities adopted by Kaduna state government – with the policy, people with disabilities can claim their rights. It will encourage others to adhere to the policy and will make people more committed towards implementation.

The implementation of the policy is ongoing, so the government must engage organisations of people with disabilities. We play an oversight role – when we notice a change in the community, or when the rights of people with disabilities are infringed, we have to follow up to see that implementation is being sustained. Sightsavers has done a lot for people with disabilities, especially in this inclusive family planning project. The government has to leverage this and sustain what they’ve started to deliver better conditions for people with disabilities.

What more can governments, donors and health partners do?

I have a message for them: in Kaduna state, we have 255 facilities and it’s a very big state with a population of about 10 million. We have a high number of people with disabilities – this project covered two local governments out of 23 and these were metropolitan local governments. We also need to address medical health in some of our rural communities. I would like them to do more, to reach out to more communities, more facilities and train more health care service providers so we can reach more people with disabilities. The governments should join hands with non-governmental organisations like Sightsavers so we can bridge those gaps.

I want to say thank you to Sightsavers for bringing the project to Kaduna. Even after the project’s lifespan, the organisations of people with disabilities will keep the project going.

So many things came out in the workshops. Some people didn’t know they had access to family planning at all

Author


Salome Luka Net has a visual impairment and is executive director of the Heart-to-Heart Inclusive Education Foundation, which has helped to deliver Inclusive Futures’ family planning project in Nigeria.

The project is led by Sightsavers and funded by UK aid under the Inclusive Futures disability inclusive development initiative.

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