Review Paper: Sexual and Reproductive Health Challenges in Women With Physical-Motor Problems and Their Solutions

Abstract

Objective The purpose of this study is to identify the sexual and reproductive health challenges in women with physical-motor problems in five domains of sexual health, screening for common diseases, maternal health, prevention of unwanted pregnancy, and sexually transmitted diseases. Materials & Methods This review study was conducted in 2016. Articles on the related topic  were searched in the following databases: Proquest, Scopus, Springer, Cochrane, ScienceDirect, Iranmedex, MagiranIrandoc, SID, and Ovid. A total of 61 related research papers, including quantitative and qualitative researches in English and Persian, from the last 15 years papers (from 18 different countries since 2000) were included in this study. Articles with unknown sample size and methodology or those conducted only on mentally handicapped individuals or men were excluded. In addition, articles with no full text access were also excluded. Results It was found that, in the majority of communities, there was a lack of knowledge about disabilities and how to provide health services to women with physical-motor problems. Insurance and financial problems were the most common reasons for inaccessibility to health care. Other problems included the lack of physical access to health centers, negative attitudes of service providers, lack of effective communications, unfriendly physical structure, and lack of equipments. The Pap smear and mammography screening services were very poor; most of these services did not have the necessary approval from doctors. Other causes included lacking necessity of performing the test, physical and cognitive limitations, and lacking access to the facilities. In addition, low knowledge and poor family planning care were also evident. In Iran, people with disabilities had received significantly less care and family planning. Most of these women considered pregnancy and childbirth to be normal . Despite the differences in the provision of services in pregnancy and childbirth, the participants expressed positive experience during this period, although they did face increased complications of pregnancy and delivery. These women are at risk for sexually transmitted diseases and are provided with weak sexual counseling about sexuality because most of the doctors believed that they have no sex.  Conclusion Thus, due to the low knowledge and received  sexual-reproductive health care in this group, community awareness, particularly for those related to the disabled individuals, is one of the main programs that can lead to the understanding and proper achievement of techniques for family and community adaptation. This will also improve the rehabilitation services. It is important to devise a way to increase the attention of the concerned authorities toward the people with disabilities for better implementation of health policies for such individuals.

Keywords

• Physically handicapped
• People with disability
• Sexual health
• Reproductive health