Sex education and people with disabilities

Sexual education is widely taught in schools the world over. Decula (2014) observed that the majority of children with disabilities, however, are not in school. This was also previously observed by UNICEF (2007). Mpofu et al. (2017) and Mukhopadhyay (2012) observed that people with disabilities in Zimbabwe generally face challenges in accessing formal education. There had been strong arguments that education facilitates access to sexual and reproductive services (Godia 2013; Morris 2015), with people who are educated being better able to access information on sexual issues. Furthermore, they are well able to make informed decisions. Education has been used to empower people in all facets of life. The fact that a lot of people with disabilities in Zimbabwe do not have access to primary education is a signal that they face a lot of challenges in accessing sexual and reproductive health information.

Whereas a number of non-governmental organisations in Zimbabwe, such as Sign of Hope and Leonard Cheshire, have tried to provide information on sexual and reproductive issues, the number of people with disabilities they have reached is still not sufficient to make any impact on the ground (Rugoho in press). Most people with disabilities are reluctant to be seen attending discussions run by these groups because of the discrimination and stigma attached to them by society. The authors argue that people with disabilities may be shy to attend group discussions because of their low self-esteem. Low levels of education amongst people with disabilities in Zimbabwe may be another reason for such low self-esteem. Rugoho and Maphosa (2015), on studies on gender-based violence, noted that it is females with disabilities who are more affected by low self-esteem, in comparison with their male counterparts.

Attitudinal barriers by services providers in Zimbabwe

Negative attitudes about and towards people with disabilities exists in almost all communities and these have the potential to create major barriers in the lives of these community members in Zimbabwe, as reported by Rugoho and Maphosa (2017). Most of these negative attitudes are found in the areas to do with the sexual and reproductive health of people with disabilities. Negative attitudinal barriers by health service providers have been noted across a number of countries (Badu 2018; DeBeaudrap et al. 2019; Rugoho 2017). Stereotypes and lack of knowledge concerning disability are some of the major causes by which people form negative attitudinal barriers. In an empirical study conducted by Rugoho and Maphosa (2017), on access to sexual and reproductive health information for women with disabilities, one of the major challenges noted by participants was negative attitudes by healthcare personnel. Healthcare providers in Zimbabwe reported negative attitudes towards sexual and reproductive health issues affecting people with disabilities. This had a detrimental effect on the subsequent desire of these people to seek out sexual and reproductive services. One of the participants in that study said:

1 visited the clinic when I was pregnant with my fourth child. The nurses said very hurtful things to me. They said I was giving birth like a dog. They said they pitied the men who introduced me to sex because I was no longer able to control my sexual feelings. I will never go back to that clinic again.

The government of Zimbabwe has not made attempts to improve the attitudes of its healthcare providers regarding sexuality issues for people with disabilities. For example, there does not appear to be any specific information or training on sexuality with respect to people with disabilities.

Physical barriers

Most of the health centres in Zimbabwe were built without people with disabilities in mind. In particular, people with physical and visual disabilities face a lot of accessibility challenges in these facilities. Owusu and Owusu-Ansah (2011) acknowledged that physical barriers may prohibit accessibility for people with disabilities from seeking healthcare. For example, most of the health centres in Zimbabwe are not wheelchair accessible. Another participant in the study by Rugoho and Maphosa (2017) said:

The clinics do not have ramps to help those in wheelchairs, like me. One day, I decided to go to the clinic to ask for information on sexual and reproductive health. I had problems negotiating my way around the buildings. When I asked for help, the nurses told me that they could not help and that I should have come with my relatives to aid me. I was so humiliated and frustrated that I developed a headache, for which I ended up getting treatment and forgot about the information on sexual and reproductive health.

(Rugoho and Maphosa 2017)

It is not only wheelchair users who face physical challenges at these health centres. Documents related to these health centres are not offered in Braille. This means that people who are blind or visually impaired have to rely on the help of other people to access the information in these documents.

 
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