Determinants of access and use of contraceptives among youth with disabilities in Nakawa Division Kampala

Abstract

Introduction: Sexual and Reproductive Health (SRH) of the Youth with Disabilities (YWDs) remains a relatively new and sensitive area mainly due to restrictive norms and policies guiding the services. In Uganda while guidelines on access and use in this population exist, the access and use of contraceptives as a sexual and reproductive component among YWDs is limited, yet no adequate literature documents this gap. This study aimed to establish the determinants of access and use of contraceptives among YWDs in Nakawa division to generate information that may be used to develop interventions to ensure holistic provision of sexual and reproductive services. Methodology: A cross-sectional study that employed both quantitative and qualitative data collection methods was conducted. Data were collected from 218 YWDs using questionnaires and in-depth interviews held with six YWDs in Nakawa division. Consecutive sampling combined with purposive sampling was used to select the YWDs aged 15 to 24 years. Results: Results showed that discussion about contraceptives with support groups in the community predicted contraceptives access (AOR =5.29; 95% CI: 1.67-16.84; p = 0.005) and contraceptives use (AOR=4.40; 95% CI: 1.66-11.69; p= 0.003). The age (AOR= 0.45; 95% CI: 0.24-0.84; p= 0.012) and socio-economic status (AOR =0.29; 95% CI: 0.10-0.86; p = 0.026) were the others determinants of contraceptives use among YWDs. In addition, physical inaccessibility and negative health worker attitude were setbacks to contraceptive access as well as general lack of knowledge on how to use contraceptives. Conclusions and Recommendations: Moral support from friends in form of discussions, age, socio economic status and distance to the nearest health facility were determinants of access and use of contraceptives among YWDs. Physical inaccessibility, negative health worker attitude, challenging experiences were experiences encountered by YWDs during access and use of contraceptives. Also being protective and good for child spacing were some of the good experiences of youth with disabilities. Recommendations: The Civil Society Organizations concerned with persons with disabilities should advocate for appropriate designing and construction of health facilities. The leaders of YWDs should design approaches that promote group formation in their normal operations as a

way of helping YWDs increase access to contraceptives. In addition, the administration of health facilities should design and institute counseling and training sessions aimed at changing the attitudes of health workers towards YWDs if the access and use of contraceptives among YWDs is to be promoted.