Case Studies on Leaving No One Behind

14. Addressing gender‑based violence and supporting sexual and reproductive health and rights for persons with disabilities

Leyla Sharafi

Women and young persons with disabilities face violence and barriers to their health and rights

Persons with disabilities have historically been left behind, including in terms of protection from gender‑based violence and the realisation of their sexual and reproductive health and rights. Around one billion people, about 15% of the population, will experience some form of disability in their lifetime. Within that billion, around 180 million youth aged 10-24 currently live with a disability; 80% of whom reside in low‑income countries. They are three times more likely than other people to experience physical, emotional and sexual violence.

Women with disabilities are ten times more likely to be sexually assaulted than women without disabilities (WWDA, 2007[1]), and they are almost without exception denied the right to make decisions about their reproductive and sexual health, increasing their risk of unplanned pregnancy and sexually transmitted infection as well as sexual violence. Young persons with disabilities are up to four times more likely to face violence than their peers without disabilities, and are often perceived as not needing information about, or capable of making their own decisions about, their sexual and reproductive lives (Jones et al., 2012[2]). In one study in Ethiopia, just 35% of young people with disabilities, including young women, used contraceptives during their first sexual encounter, and 63% had had an unplanned pregnancy (Kassa et al., 2014[3]).

Raising awareness on the rights of persons with disabilities and actions that work

UNFPA launched WE DECIDE in 2016 to promote the rights of women and young persons with disabilities, with the programme’s name emphasising, above all, their rights to make decisions regarding their health, education, employment and life aspirations. The programme adopts a twin-track approach of supporting targeted activities and mainstreaming disability into other areas of work, both within UNFPA and with national partners. The programme is a clear commitment to the principle of leaving no one behind, and a way of supporting member states fulfil their obligations under the Convention on the Rights of Persons with Disabilities. It has raised global awareness and strengthened evidence and programming on the rights and needs of persons with disabilities, particularly regarding gender-based violence and sexual and reproductive health and rights.

As part of the programme, in 2018 UNFPA published the major study Young Persons with Disabilities: Global Study on Ending Gender-based Violence and Realizing Sexual and Reproductive Health and Rights (UNPF, 2018[4]). Through the programme they also developed, with Women Enabled International, a set of guidelines entitled Women and Young Persons with Disabilities: Guidelines for Providing Rights-based and Gender-responsive Services to Address Gender-based Violence and Sexual and Reproductive Health and Rights to offer practical and concrete actions that governments, service providers and other relevant stakeholders can take to meet these needs of women and young persons with disabilities (UNPF and WEI, 2018[5]).

WE DECIDE was implemented successfully within a number of countries. In Ecuador, UNFPA in co-ordination with the Ministry of Health, the National Council for Gender Equality and the National Council of Disabilities developed a guide on addressing sexual and reproductive health and rights for persons with disabilities. They also commissioned research on pregnancy among adolescents with disabilities, its links with gender-based violence, and the challenges regarding their health care. This work is providing more evidence and know‑how for the government and civil society, and ultimately supporting stronger policies, as demonstrated by the prioritisation of these issues in Ecuador’s National Sexual and Reproductive Health Plan.

In Morocco, UNFPA conducted a baseline study on sexual and reproductive health and gender-based violence among young women and girls with intellectual disabilities. Through the programme, UNFPA worked with service providers to develop a protocol for early detection and guidance on gender-based violence for persons with intellectual disabilities, with a particular focus on young women and girls. They also developed a training module on social inclusion for various partners and civil society, while raising awareness about the sexual and reproductive health and rights of young persons with disabilities among communities, families and young people themselves.

In Mozambique, UNFPA raised awareness with Civil Society Organizations and Disabled Persons Organizations regarding persons with disabilities’ rights to sexual and reproductive health, and related national policies. The programme made services and information on sexual and reproductive health more accessible, worked to increase the capacity of key actors in civil society, and strengthened skills among the service providers at youth-friendly centres to be more inclusive of young people with disabilities.

Strong commitment at a senior level and partnerships on the ground

The success of the programme is closely tied to committed senior leadership within UNFPA, dedication of resources, and institutionalisation of the issue into the Fund’s Strategic Plan 2018-2021. At the same time, working with civil society, and with young persons and women with disabilities directly, has helped build a strong programme that reflects genuine needs and demands. It was also important to have data and statistics ready to engage in advocacy, both within the organisation and externally.

What next?

UNFPA will continue implementing the programme by rolling out and disseminating key knowledge products, including the Global Study and Guidelines. It will continue to support governments in fulfilling their commitments to the rights of persons with disabilities, particularly in terms of ending gender-based violence, and ensuring they can realise their sexual and reproductive health and rights. Under the framework of UNFPA’s Strategic Plan, UNFPA will continue to provide tools, evidence and intervention models at country level, and support persons with disabilities, particularly, women and young persons, to participate within the programme and beyond.

References

[2] Centre for Public Health, L. (ed.) (2012), Prevalence and risk of violence against children with disabilities: a systematic review and meta-analysis of observational studies, Lancet, http://dx.doi.org/10.1016/S0140-6736(12)60692-8.

[3] Kassa, K. et al. (2014), Sexuality and sexual reproductive health of disabled young people in Ethiopia, Sexually Transmitted Diseases, http://dx.doi.org/10.1097/OLQ.0000000000000182.

[4] UNPF (2018), Young Persons with Disabilities: Global Study on Ending Gender-Based Violence and Realizing Sexual and Reproductive Health and Rights, United Nations Population Fund, http://www.unfpa.org/publications/young-persons-disabilities.

[5] UNPF and WEI (2018), Women and Young Persons with Disabilities: Guidelines for Providing Rights-Based and Gender-Responsive Services to Address Gender-Based Violence and Sexual and Reproductive Health and Rights for Women and Young People with Disabilities, United Nations Population Fund and Women Enabled International.

[1] WWDA (2007), Forgotten Sisters - A global review of violence against women with disabilities, Women With Disabilities Australia, http://wwda.org.au/wp-content/uploads/2013/12/Forgotten_Sisters.pdf.