Lived experiences of barriers to sexual and reproductive healthcare for people with sensory and physical disabilities in Bulawayo, Zimbabwe

Abstract

BACKGROUND: Zimbabwe has ratified international agreements and developed national policies, such as the National Disability Policy (2021), promoting the rights of people with disabilities (PWD). However, a significant gap persists between policy and the lived reality of PWD accessing sexual and reproductive health (SRH) services. Therefore, this study aimed to explore the lived experiences of people with sensory and physical disabilities in accessing SRH services in Bulawayo, Zimbabwe. METHODS: A qualitative study was conducted in Bulawayo Metropolitan Province of Zimbabwe. Twenty participants with sensory and physical disabilities were recruited to represent diversity in gender, age, and disability type. In-depth, semi-structured phone or text message interviews depending on participant need and preference, until data saturation was reached. Data were analysed using reflexive thematic analysis, following a six-step process to ensure analytical rigour. RESULTS: Four themes were identified: (1) structural and infrastructural barriers; (2) financial exclusion due to multiplied costs; (3) systemic communication failures; and (4) pervasive stigma and discrimination from healthcare providers. These barriers intersect to limit SRH access and result in unmet sexual and reproductive needs, unwanted pregnancies, and avoidance of healthcare facilities. CONCLUSION: Despite a progressive policy environment, the implementation of disability-inclusive SRH services in Bulawayo is critically weak. Urgent action is required, including mandatory disability sensitivity training for all healthcare workers, investment in accessible infrastructure and assistive communication devices, enforcement of accessibility standards through regular audits, and engagement with disability advocacy groups to monitor policy compliance. These measures are essential to bridge the gap between law and practice and uphold the SRH rights of PWD.