PATTERN OF USE AND ACCESS TO SEXUAL AND REPRODUCTIVE HEALTH SERVICES AMONG WOMEN WITH DISABILITIES IN LAGOS, NIGERIAN.

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Background: Sexual and Reproductive Health (SRH) is crucial for overall well-being, yet persons with disabilities (PWDs), especially women, encounter significant challenges in accessing SRH services, impacting their quality of life. Objectives: To assess the awareness, patterns, barriers, perceived enablers and predictors of utilization of SRH services among women with disabilities in Lagos, Nigeria. Methods: This was an analytical cross-sectional study involving 231 women of reproductive age with disabilities who were recruited through snowball sampling. Data were collected using semi-structured questionnaires and analyzed with SPSS version 21. Descriptive statistics summarized socio-demographic, economic, and disability-related variables. Pearson Chi-squared and logistic regression analyzed associations and predictors of use, with statistical significance set at p<0.05. Results: The mean age was 32.2 ± 8.5 years; 39.4% had secondary education and 48.5% were unmarried. High awareness of SRH services was reported (93.3%), with 64.9% having utilized SRH services, mainly pregnancy testing (65.3%) and HIV counseling and testing (57.3%). The main barriers were treatment costs (80.7%), difficulty in physical access to health facilities (53.3%), long wait times (47.3%), and negative attitude of health workers (42%). Perceived enablers include subsidized treatment, improved transport, and reduced wait times. Predictors of utilization of SRH services include adult-onset disability compared to pre-adulthood (AOR=432.708, 95% CI=22.392, 8361.882), being physically disabled (AOR=0.140, 95% CI=0.033, 0.586), and having a hearing impairment (AOR=0.124, 95% CI=0.017, 0.903) compared to visual impairment. Conclusion: Despite high awareness, women with disabilities face barriers to accessing SRH services due to costs, accessibility issues, and long waiting times. The health system in collaboration with other relevant sectors should implement interventions to ensure adequate inclusion to improve their access and utilization of SRH services, in addition to improving the QoC.

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