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Are women with disabilities less likely to utilize essential maternal and reproductive health services?—A secondary analysis of Pakistan Demographic Health Survey

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  • Shafaq Mahmood
  • Waqas Hameed
  • Sameen Siddiqi

Abstract

Background: People with disabilities deal with widespread exclusion from healthcare services, including sexual and reproductive health (SRH) rights. Studies analyzing the relationship between disability and key SRH utilization outcomes have often reported mixed findings. In Pakistan, very little to no literature is available on this topic, therefore we aim to determine inequalities in the utilization of essential maternal and reproductive health services between women with and without disabilities in Pakistan. Methods: This was a secondary analysis of Pakistan Demographic Health Survey 2017–18 performed on a weighted sample of 6,711 women aged 15–49 years with a live birth in the 5 years preceding the survey. Six types of disabilities were assessed i.e. vision, hearing, communication, cognition, walking and self-care. Utilization of essential maternal and reproductive health services was assessed through a set of four outcome variables: (i) modern contraceptive use; (ii) skilled antenatal care (ANC); (iii) skilled birth attendance (SBA); and (iv) skilled postnatal care (PNC). Multivariate Cox regression analysis was performed to determine the association between dependent and independent variables. Data were analyzed using Stata MP Version 16.0. Results: A total of 6,711 women were included out of which 14.1% (n = 947) live with at least one form of disability. Mean age was 29.4 (S.E = 0.13) years. The most prevalent form of disability was vision (7.0%), followed by walking (4.8%), cognition (4.8%) and hearing (1.8%). Women with disabilities were comparatively less educated, belonged to older age group, and had higher parity than their non-disabled counterparts. With the exception of modern contraceptive use, which was more prevalent in the group with disabilities, women with disabilities were less likely to utilize skilled ANC, SBA and PNC in bivariate analysis. However, these associations turned insignificant in the adjusted model. Overall, no statistically significant differences were observed in the utilization of essential reproductive health services between women with and without disabilities after adjusting for important covariates. Conclusion: Our analyses did not find any statistically significant differences in the utilization of essential maternal and reproductive health services between women with and without disabilities. In-depth research utilizing qualitative or mixed methods is required to understand how well the healthcare system in Pakistan is responsive to the different needs of disabled women.

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  • Shafaq Mahmood & Waqas Hameed & Sameen Siddiqi, 2022. "Are women with disabilities less likely to utilize essential maternal and reproductive health services?—A secondary analysis of Pakistan Demographic Health Survey," PLOS ONE, Public Library of Science, vol. 17(8), pages 1-17, August.
    • Handle: RePEc:plo:pone00:0273869
    DOI: 10.1371/journal.pone.0273869
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    References listed on IDEAS

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    1. Mitra, Sophie & Posarac, Aleksandra & Vick, Brandon, 2013. "Disability and Poverty in Developing Countries: A Multidimensional Study," World Development, Elsevier, vol. 41(C), pages 1-18.
    2. Nora Groce & Maria Kett & Raymond Lang & Jean-Francois Trani, 2011. "Disability and Poverty: the need for a more nuanced understanding of implications for development policy and practice," Third World Quarterly, Taylor & Francis Journals, vol. 32(8), pages 1493-1513.
    3. Hosseinpoor, A.R. & Williams, J.A.S. & Gautam, J. & Posarac, A. & Officer, A. & Verdes, E. & Kostanjsek, N. & Chatterji, S., 2013. "Socioeconomic inequality in disability among adults: A multicountry study using the world health survey," American Journal of Public Health, American Public Health Association, vol. 103(7), pages 1278-1286.
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