Sexual and Reproductive Health Needs of People Living with Disabilities: Family Planning Practice and Need in Gusau, Zamfara State, NW Nigeria

Background In Northwestern Nigeria, Persons Living With Disabilities (PLWD) often occupy marginalized low socioeconomic spaces, often considered as an afterthought for policy decisions and regularly face discrimination and barriers to accessing basic health needs, including access to Sexual and Reproductive Health (SRH) services, as compared to their able-bodied counterparts. Objective The study aims to understand the contraceptive and family planning needs and practices of PLWD, male and female, married and unmarried, living in Gusau, Zamfara State, Northwest Nigeria. Methods This cross-sectional study utilized primary data collected from 8 focus group discussions (FGD) with adult PLWD members of local disability community support organizations in Gusau, Zamfara State and their key informants. Participants were male and female, married and unmarried. Interviews were transcribed, translated and analyzed using descriptive thematic analysis. Results Most participants in all 8 FGD groups were aware of modern contraceptive methods and preferred them due to perceived safety and effectiveness in preventing pregnancy. Motivations for contraception use were to limit the number of children to avoid the financial burden of parenting. Reasons for not using contraceptives were paradoxically attributed to needing more children for assistance in activities of daily living (particularly by visually impaired PLWD), and for perceived fear of adverse effects of the contraceptives. Other barriers to use signaled access issues, included communication challenges, stigmatization by healthcare workers, and lack of disability-friendly services at the health facilities. Conclusion We recommend policies to improve SRH access for PLWD such as prioritizing respectful and disability-friendly healthcare environment, improved access to disability-type-specific health information, enhanced communication like braille and sign language interpretation, and free family planning services.