PWD

Advancing Sexual and Reproductive Health and Rights of Persons with Disabilities in Nepal

INTRODUCTION

Background

In Nepal, there remains a significant gap in Sexual and Reproductive Health and Rights (SRHR) programs tailored specifically for persons with disabilities. Recognizing this, Family Planning Association of Nepal (FPAN) has been continuously implementing intervention activities at various levels to advance the SRHR of persons with disabilities. One such initiative is the project titled “Advancing Sexual and Reproductive Health and Rights of Persons with Disabilities in Nepal”, which has been implemented since 2019 with support from Väestöliitto (the Family Federation of Finland). The project aims to enhance the protection and enforcement of the sexual and reproductive health and rights of persons with disability.

This initiative brings together five expert organizations: Vaestoliitto, Kynnys, MSIA, Ishtirok, and FPAN to foster positive changes in three partner countries: Afghanistan, Nepal, and Tajikistan in matters concerning SRHR and/or disabilities. These changes are facilitated through national-level activities, as well as rigorous learning and sharing of best practices. The project focuses on several key areas: building the capacity of rights-holders, raising awareness within societies, strengthening the capacity of civil society, advocacy, and enhancing the learning and capacity-building efforts of program partners.

Sexual and Reproductive Health:

Access to quality SRH services remains limited due to inadequate human resources, poor infrastructure, and weak management in the public health system. Women, in particular, face barriers due to low education, literacy levels, and societal norms that restrict their decision-making power, often leaving reproductive health choices to their husbands and families. In addition, women with disabilities face barriers in accessing economic resources, financial services, and technology.

SRH is a vital part of health and sustainable development. For persons with disabilities, SRH needs are often neglected, especially in low- and middle-income countries like Nepal, where misconceptions about their lack of sexual needs persist. Barriers to accessing SRH services due to low socioeconomic status, limited availability, and high costs pose a higher burden for women with disabilities. Even when services exist, providers often lack the necessary equipment, training, and sensitivity to address their needs. Additionally, women with disabilities are two to four times more likely to experience emotional, physical, and sexual violence, including intimate partner violence, forced sterilization, and abuse.

To address these challenges, there is a growing need for an enabling environment that ensures accessible and appropriate SRH information and services for persons with disabilities. This requires multi-level strategies, including capacity building for service providers and logistical support for individuals with disabilities.

People with Disability

The National Population Census 2021 states that the overall prevalence of disability was 2.2 % in Nepal, with 2.5% prevalence of male disability and 2.0% prevalence for females. Whereas the National Living Standard Survey Report 2022/23 has claimed it to be 2.3%. However, both figures are quite low as compared to the 16% disability prevalence rate estimated by WHO. These figures are in sharp contrast to studies carried out by specific impairment groups - for example a survey carried out in five districts in 1991 stated that 16.6% of children aged over five were deaf.

According to the National Population Census 2021, physical disability was the most common type of disability, which accounted for more than one-third of total disabilities. Disability in urban residents was more prevalent (58.1%) compared to disability in their rural residents (41.8%). Persons with disabilities are 7 times more likely than others to not have access to health care when they need it, and this includes sexual and reproductive health needs. Studies addressing the SRH needs of persons with disabilities are not available in Nepal.

Project Partners

From the outset of the project, FPAN has collaborated/partnered with four Organizations of Persons with Disabilities (OPDs) in the Kathmandu Valley-two from Kathmandu, one from Lalitpur, and one from Bhaktapur. These OPDs have been essential partners in supporting the project. The names of the collaborating OPDs are as follows:

• Action on Disability Rights and Development-Nepal (ADRAD-Nepal)
• Nepal Disabled Women Association (NDWA)
• Blind Youth Association of Nepal (BYAN)
• Community-based Based Rehabilitation (CBR)

Besides these OPDs, the project was expanded to a new operational area (Banke district) from 2023. Since its implementation in the new area, the following local partners from Banke have been supporting the project:

• Disable Empowerment and Communication Center (DEC) Nepal,
• Parent Association Person with Intellectual Disability (PAPID),
• National Disable Albino Nepal,
• Banke Association of Blind (BAB).

Project Location:

Overall goal of the project

• Improving Sexual Reproductive Health and Rights (SRHR) of People with Disability (PwD)

The project is implemented in Nepal under the following key outputs:

Output 1 - Capacity building of rights holders

Output 2 - Awareness raising in societies

Output 3 - Capacity building in civil society

Output 4 - Advocacy in program countries

Output 5 - Learning and capacity building of program partners

The project intends to “contribute to the realization of sexual and reproductive health and rights (SRHR) of the most vulnerable groups, while also supporting the realization of Sustainable Development Goals (SDGs) 3.7 and 5.6”.