The Delivering Equitable and Sustainable Increases in Family Planning (DESIP) programme has been instrumental in promoting social inclusion, particularly focusing on disability inclusion in family planning (FP) and sexual and reproductive health (SRH) services across Kenya. The programme recognizes the challenges faced by persons with disabilities (PWDs) in accessing FP services due to systemic barriers, discrimination, and societal misconceptions.
Understanding Social Exclusion and Barriers
DESIP conducted a Social Exclusion and Gender Analysis (SEGA) to assess power dynamics, policy frameworks, and the drivers of exclusion.
This analysis revealed key barriers for PWDs, including:
Many PWDs are viewed as asexual or incapable of engaging in relationships, leading to their exclusion from FP services
Deaf and visually impaired individuals struggle to communicate with healthcare providers.
Many healthcare facilities lack accessible equipment such as adjustable examination couches.
Transportation challenges disproportionately affect PWDs, making it difficult for them to access FP services.
Principles of Inclusion in DESIP
To address these barriers, DESIP adopted an inclusion framework based on Acceptability, Availability, Accessibility, and Quality (3As & Q):
Ensuring FP services are culturally sensitive, ethical, and respectful of age, gender, and disability.
Strengthening public health systems to ensure services, facilities, and commodities are available for PWDs
Promoting non-discrimination, economic affordability, and physical accessibility of health services and information
Ensuring that information and services provided are medically appropriate and inclusive
Key Interventions by DESIP
To integrate social and disability inclusion into Family Planning services, DESIP implemented several initiatives:
- Conducted training for healthcare workers (HCWs), partners, and religious leaders on disability inclusion.
- Oriented the Ministry of Health’s Division of Reproductive Health on FP service delivery standards to incorporate disability inclusion.
- Provided technical assistance to 24 Social Inclusion Champions (HCWs trained in disability and gender inclusion).
- Developed inclusive messaging on FP tailored for PWDs.
- Distributed IEC materials (Information, Education, and Communication) to partners, HCWs, and community health volunteers (CHVs).
- Created a Disability Mainstreaming Guide and a Social Inclusion Framework to standardize inclusive practices.
- Worked with Organizations of Persons with Disabilities (OPDs) to build capacity and ensure representation.
- Appointed Disability Inclusion Advisors to provide strategic guidance.
- Trained partners on using the Washington Group of Questions to track disability inclusion in FP services.
- Reviewed partner tools to ensure they captured data on PWDs’ access to FP/SRH services.
- Developed a Social Inclusion Tracker to document interventions and ensure accountability in implementing inclusive policies
Results and Achievements
DESIP’s targeted approach to social inclusion resulted in significant milestones:
- Reaching PWDs: Over 3,500 PWDs were reached with FP services. The inclusion of disability in health systems improved through infrastructure modifications and the development of disability-inclusive FP guidelines.
- Health System Strengthening: HCWs were equipped with resources and training to serve PWDs better. The introduction of disability-friendly materials, such as simplified sign language reproductive health charts and pocket booklets for HCWs, further enhanced service delivery.
- Youth and Adolescent Engagement: Peer-led interventions, combined with the use of digital platforms and partnerships with youth organizations, significantly improved access to SRHR services for young people.
- Support for Rural Women: Through the efforts of CHVs and community outreach, rural women gained better access to FP services, overcoming geographical and economic barriers.
