Disability inclusion in maternal health services in Mozambique: a mixed-methods analysis of barriers experienced by women with disabilities

Résumé fourni par la source

BACKGROUND: In Sub-Saharan Africa, maternal health remains a significant public health challenge, and women with disabilities (WWD) experience profound inequities in access to essential healthcare services. In Mozambique, although national strategies promote disability inclusion, systemic and structural barriers continue to undermine equitable access to maternal health services. This study explores the intersection of maternal health and disability inclusion in Mozambique, identifying barriers faced by women with disabilities and opportunities to improve service accessibility and quality. METHODS: A mixed-methods design was employed, integrating a desk review with stakeholder consultations and an interactive workshop. The desk review examined national policies and relevant literature on maternal health and disability inclusion in Mozambique. Stakeholder consultations were conducted via surveys across multiple regions, engaging WWD, healthcare providers, policymakers, and disability advocates. Key findings were validated and refined through participatory workshops involving diverse stakeholders. Quantitative data were analysed descriptively, while qualitative responses were thematically analysed. RESULTS: The study found that women with disabilities in Mozambique face multifaceted barriers to maternal health, including inaccessible infrastructure, lack of adapted medical equipment, financial constraints, inadequate provider training, communication gaps and stigmatizing attitudes. Among 81 surveyed participants, over 80% reported physical and communication barriers as major obstacles, while 62% reported attitudinal barriers. Although some participants noted the existence of policies such as the National Action Plan for Disability and the Strategy for People with Disabilities in Public Services, their implementation was widely perceived as ineffective or insufficient in improving maternal health service accessibility for women with disabilities. CONCLUSION: Disability inclusion within Mozambique's maternal health system remains limited, with policy commitments insufficiently translated into practice. Achieving equitable and inclusive maternal healthcare for women with disabilities in Mozambique requires sustained investment in accessible infrastructure, provider training, community engagement, and effective accountability mechanisms. Addressing these systemic barriers is critical to improving maternal health outcomes and advancing health equity for all women in Mozambique.

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