In Nigeria, women with disabilities face daunting challenges when it comes to accessing adequate healthcare services.
Hindered not only by their disabilities but also by the lack of inclusive public health facilities, these women are often left unseen and underserved by the system.
This report by AllNews.ng's Maureen Okpe aims to shed light on the struggles faced by women with disabilities in Nigeria and the dire need for improved public healthcare facilities that cater to their specific needs.
The Nigeria Health Watch report of 2022 disclosed that over 29 million people are living with disabilities in the country. Despite this huge number, many public buildings have no wheelchair access, poor signage, narrow doorways, internal steps, inadequate bathroom facilities and inaccessible parking areas.
Disability inclusion ensures that persons with disabilities are included in everyday activities; encouraging them to have roles similar to their peers who do not have a disability. It requires making sure that adequate policies and practices are in effect, implementing those policies and encouraging organisations and companies to adopt them.
Experts believe making services disability inclusive does not just benefit people with disabilities, it benefits everyone. An easily accessible building may also help a pregnant woman, or plain language medical documents may be easily understood by young and elderly people.
Maternal health burdens
In 2019, the Discrimination Against Persons with Disabilities (Prohibition) Act 2018 was signed into law. Some of the provisions made by the act include the right to employment, education, health and accessibility of physical structure.
One critical aspect further highlighted is maternal healthcare for women with disabilities. Pregnancy and childbirth pose additional risks and complications, requiring specialized attention and support. However, the current public health system does not adequately address the unique needs of pregnant women with disabilities.
Women with disabilities confront a multitude of barriers in accessing healthcare, exacerbating the challenges they already face. Physical infrastructure, transportation, and communication gaps hinder their ability to reach healthcare facilities, this is as many facilities in Nigeria lack wheelchair ramps, appropriate medical equipment, and accessible waiting areas, creating additional obstacles for these women. As a result, they are often forced to forego routine check-ups, delay necessary treatments, or rely on inadequate services.
Recounting her ordeals and experiences in the health care visited over the years, Women Secretary, Karmajiji Disabilities community, Rabi Mustapha said unprofessional treatment meted out at the health facilities at a time prevented her from seeking further medical care when needed.
Mustapha lamented, “They treat us persons with disabilities as second-class citizens, most times, they will ask us to wait while they attend to other people regardless of our health condition, not even if it is an emergency case; they make us wait all the same.
A gynaecologist with a government hospital in the FCT, who pleaded anonymity, said the health sector lacks the required equipment needed in the hospitals to ease cases of pregnant women, and some when available, it is just not enough to serve the influx of patients to be treated.
He said the cases of persons with disabilities are usually very tough because the necessary technologies to assist them are seen as extra budget, and are not readily available.
"These situations are demeaning, like when treating a pregnant woman who has lost the use of her legs, to be able to check her up during antenatal, the nurses or caregivers will have to carry her to the examination table which should not be. If we have the lowering bed which can be reduced for the patient to climb and we raise it again, it will make better sense and keep intact the dignity of the patient.
"In this hospital, if a deaf person comes for treatment and is not accompanied by a caregiver or sign language interpreter, automatically she will not be able to get the needed attention she requires because how do we get to communicate? It is almost impossible," he said.
Effective communication between healthcare professionals and their patients is critical to providing high-quality healthcare.
This communication is vital because it enables patients to fully understand their diagnoses, treatment options, and aftercare instructions. For individuals who are deaf or blind, effective communication becomes even more critical.
Misdiagnoses, inadequate treatment, and overall patient dissatisfaction may result from failing to satisfy these distinct communication needs in healthcare settings, experts have said.
Alternative communication methods, such as written communication, speech-to-text technologies, and video relay services, as well as sign language and understanding the complexities of being deaf, would help.
It is believed that healthcare providers that can effectively engage with deaf patients not only demonstrate respect for their patient’s particular needs but also contribute to an improved patient experience.
Executive Director, Deaf Women Aloud Initiative (DWAI) Hellen Beyioku-Alase noted the uneasy encounters persons with disabilities experience in accessing health facilities in Nigeria, reiterating the need for the provision of sign language interpreters in the health centres to break the communication barriers that exist between the disability patient and the doctor.
Beyioku-Alase stressed that the system is difficult for everyone, and even more so for persons with disability as the inadequacy of health centres to meet their needs due to communication barrier creates a huge challenge.
She said, "The major challenge the deaf community faces in accessing health services is communication, once this challenge is sorted out through the availability of sign language interpreters at medical facilities, access to healthcare will be seamless just like every other person in the society.
"Being deaf has not been easy but I carry on with life and contribute my quota to the development of our nation as much as I can."
Inadequate training, sensitization
Over time PWDs have lamented that another contributing factor to the lack of access is the inadequate training and sensitization of healthcare professionals.
They insisted that providers often lack the knowledge and skills needed to understand and address the specific healthcare needs of women with disabilities. This knowledge gap results in misdiagnoses, ineffective treatment plans, and deep-seated biases that hinder proper care provision.
Gender and Social Inclusion Advocate, Sussan Kelechi Ihuoma, calls for the capacity to strengthen health workers on issues of Persons With Disabilities and knowledge of the act. She stated that training programs and sensitization initiatives are crucial in ensuring healthcare workers are equipped to provide inclusive and comprehensive care.
Ihuoma urged continuous sensitization of the people, educating them on the essence, maintaining that, disability rights are human rights and should be treated as such, "because for an emerging society like ours to thrive, we must leave no one behind.
"Sensitization of healthcare providers is pertinent in line with the provisions of the Disability Act. This will help them serve us better with an in-depth understanding of disability issues.
"Disaggregated data in our NHMIS will help the government and stakeholders to put adequate structures in place like ramps, information in an accessible format, weighing scale that can accommodate wheelchair users for our sexual and reproductive services moving forward.
"I don't think that assistive devices to aid access to health services for persons with disability are available if they exist, they are very few and this makes persons with disability avoid the use of health facilities, especially government facilities."
The Head of Women and Gender, National Commission for Persons With Disabilities (NCPWD), Patience Ogolo-Dickson decried the difficulty of accessing health facilities in Nigeria as a woman with disability.
She said, "We have lots of barriers, physical, communication among others that speak and work against the likes of PWDs.
"As a woman, it is difficult accessing health facilities because of the barriers. The health workers are not friendly at all and some who do, lack the capacity to care for the needs of the women with disabilities.
"They see persons with disabilities based on negative mindset, stereotyping, what they hear in the communities they bring it to the facility, and this is wrong.
"The truth is that we need a society that is more inclusive, that speaks and accepts Persons With Disabilities as equal as others. We are not different people, we are the same, it is just that we function differently."
The Critical Role of Government
The Nigerian government plays a vital role in addressing the healthcare gaps faced by women with disabilities. However, there is a pressing need for increased investment in the public healthcare sector to improve infrastructure, equipment, and staffing.
It is believed that policies must be enforced to ensure accessible and inclusive healthcare for all citizens, regardless of disability.
Attempts to speak with the Hospital Management Board Executive Director in Abuja failed as our reporter constantly met his absence at every attempt.
The Head of the Gender Desk of NCPWD, Ogolo-Dickson, speaking on the Discrimination Against Persons With Disability Act, expressed appreciation to the government for creating a voice for the PWD, stating that through the establishment of the commission, various engagements have been carried out to further reduce the plights of the community.
She said in implementing the National Disability Act, Nigeria has made some progress towards achieving a disability-inclusive society by passing the National Disability Act which has been domesticated in some of the 36 states in the country.
She noted that the PWDs community through the commission has been recognized and collaborated with to further highlight assistance and issues of persons with disabilities.
However, according to her, the Act has not been fully implemented so government — at all levels, policymakers, partners and advocates must make concerted efforts to address the barriers that make it difficult for people with disabilities to function and ensure full implementation of the National Disability Act.
Ogolo-Dickson said, "Although it has not been easy the disability act is a blessing to the community. We have fought for it for a long time.
"The disability act did not just give us a bill but also a commission. That is why we have a voice. When you have a framework, it tells you the direction.
"In the commission, we have the Department of Compliance and Enforcement which ensures that the stipulated laws are followed. After the moratorium, they will check for compliance and how organisations have been able to follow the laws and make any modifications necessary.
"We thank God that the awareness is increasing, the commission is working on a framework so that everyone will know the right action and direction to take."
Stakeholders in the health sector reiterated that the lack of access to public healthcare facilities for women with disabilities in Nigeria is a grave concern that demands immediate attention.
They believe the Nigerian government must prioritize inclusive healthcare policies, invest in infrastructure, and implement accountability measures to bridge the healthcare gap. Only through collaborative efforts between government, healthcare providers, and communities can Nigeria ensure that women with disabilities have equal access to quality healthcare, thus empowering them to lead healthier, fuller lives.
This report is for the Gender Accountability and Inclusivity in Nigeria (GAIN) project for Gender Strategy Advancement International (GSAI) supported by the Open Society Initiative for West Africa(OSIWA).