The triple burden: achieving sexual and reproductive health equity for young women with albinism in Rwanda

Abstract

Young women with albinism in Rwanda face a triple burden of intersecting stigma related to gender, disability, and albinism-specific myths, yet their sexual and reproductive health (SRH) needs remain largely invisible in research, policy, and practice. Despite Rwanda´s progress toward universal health coverage and disability inclusion, no published studies specifically examine SRH access, outcomes, or barriers among this population. Drawing on intersectionality theory and evidence from separate bodies of literature on gender, disability, and albinism in East Africa, this perspective article argues that overlapping discrimination likely creates unique and compounded obstacles to contraception, antenatal care, sexually transmitted infection (STI) services, and freedom from sexual violence. Cultural beliefs portraying albinism as a curse or conferring supernatural properties perpetuate social exclusion, internalized shame, and heightened vulnerability to gender-based violence. Visual impairment associated with albinism compounds accessibility challenges, while the absence of low-vision materials, genetic counselling, sun-protection guidance, and provider training on albinism further limits equitable care. National SRH and disability frameworks mention persons with disabilities broadly but lack tailored provisions for albinism. To achieve true health equity, Rwanda must make young women with albinism visible through disaggregated data collection, explicit integration into SRH policies, accessible materials and facilities, mandatory provider training, and community-led myth-busting initiatives. Primary research co-designed with women with albinism is urgently needed to document their lived experiences and evaluate interventions. Addressing these intersecting barriers will strengthen inclusive SRH services for all marginalized groups.