Barriers to reproductive health services for women with disability in low- and middle-income countries: A review of the literature.

The aim of this literature review is to determine the existing literature regarding access to reproductive health services for women with disabilities in low- and middle-income countries. PubMed, Web of Science, and EBSCOHost Global Health were searched for articles focused on this topic. A total of 16 articles were included in the review. Of these, nine were qualitative, two were mixed-methods, two were literature reviews, one was a policy review, one was a descriptive cross-sectional study, and one was a case-control study. The studies took place in eleven countries in Africa and Asia. Data was extracted from the articles and analyzed using Levesque's Model of Healthcare Access to determine themes apparent in the articles. Key barriers to access included: negative attitudes of providers and society; lack of trained providers; assumptions and inadequate knowledge amongst providers; communication limitations; inaccessible facilities; lack of transportation; high costs of care; unnecessary referrals; and risk factors like being low-income or experiencing violence. Based on this analysis, policies mandating inclusion of people with disabilities are necessary. Also, providers must receive additional education and training regarding disability. Facilities and transportation should be accessible for people with mobility and sensory limitations. Future research needs to be conducted to determine reproductive health service use and outcomes amongst women with disabilities. Datasets for reproductive health should disaggregated based on disability status to facilitate this research.