We must create better opportunities for women and children with disabilities.

When disparities due to gender, disability and age intersect, these driving factors widen inequities, intensifying exclusion.

The time is now to turn the clock forward on women’s rights. March is an empowering and significant month for women and girls globally, with it being Women’s History Month, International Women’s Day (IWD), Women’s Week and the UN Commission on the Status of Women (CSW66). As we spend the month celebrating women and girls, their contributions to history, culture and society, and advocating for their further equity and opportunity, we must highlight women as active supporters and claimholders of development. No nation can advance progressively in any sector without the contributions of all women. 

Despite the enormous and undeniable contributions women and girls make to their communities, they continue to be marginalized and deprived due to gender inequality. “Gender equality today for a sustainable tomorrow” is this year’s IWD theme, and I had the pleasure to expand on this subject with Radio Nigeria on IWD – March 8th in association with Partnership for Maternal, Newborn and Child Health, in the lead up to the UN Commission on the Status of Women (14-25 March, 2022). 

I truly believe that achieving gender equality and the empowerment of all women and girls in the context of climate change, environmental and disaster risk reduction policies and programmes will require deliberate and intentional actions to integrate a #OneHealth approach.

Disparities due to gender, along with factors such as disability and age, respectively, are driving factors for widening inequities. When the three intersect, the negative impact of exclusion is intensified. As a result, adolescent girls with disabilities are one of the population groups facing overwhelming barriers and are left furthest behind in all walks of life. I am humbled to, in association with my Wellbeing Foundation Africa, join PMNCH global alliance for women’s, children’s and adolescents’ health to highlight these persistent disparities and their consequences. 

Disability and poverty reinforce and perpetuate one another and as such, disability has a higher prevalence in lower-income countries. 80% of people with disabilities live in developing countries, facing more frequent socioeconomic inequities than their non-disabled peers, including a higher rate of poverty, lower education level and increased rate of unemployment. Girls with disabilities experience a range and variety of impairments, including physical, psychosocial, intellectual and sensory conditions, that may or may not come with functional limitations. Compared to men without disabilities, women with disabilities are three times more likely to have unmet needs for health care, three times more likely to be denied health care, four times more likely to be treated badly in the healthcare system and 50% more likely to suffer catastrophic health expenditure.

While all people with disabilities face varying discrimination and are often invisible in policies, women and girls with disabilities are subjected to double discrimination: because of their gender as well as disability bias. Women and girls with disabilities are not a homogenous group: they include those with multiple and intersecting identities across all contexts, such as ethnic, religious, and racial backgrounds; their status as refugee, migrant, asylum-seeking, and internally displaced women; LGBTIQ+ identity; age; marital status; and living with or being affected by HIV. The disabilities being faced by women and girls are equally diverse, including physical, psychosocial, intellectual and sensory conditions, that may or may not come with functional limitations.

The pre-existing inequities and discrimination that adolescent girls face on a daily basis have been further amplified during the COVID-19 pandemic. In places hit hard by COVID-19 and others with a much lower rate of infection—women and girls with disabilities are still being left behind. They are struggling to meet basic needs, to access needed health services including those specific to their gender and disability, and face disproportionate risks of violence.  

Systemic barriers coupled with the failure to prioritize the collection of data on the situation of women and girls with disabilities have perpetuated their ‘invisibility’ within societies, as multiple and intersecting forms of discrimination exclude them from various aspects of life. Girls with disabilities have lower school completion rates and lower literacy rates than all other children, for example, and girls and women with disability face particular barriers to sexual and reproductive health (SRH) services and information.

Provision of accessible sexual and reproductive health and rights (SRHR) information and services for girls and young women with disabilities are largely non-existent, with service providers in health centres, schools, and institutions that house them ill-prepared to handle their specific needs. And when women and girls with disabilities try to access services, they can experience negative and hostile attitudes among service providers, lack of accessible buildings, equipment, and transportation, affordability of services, and isolation in institutions, camps, family homes, or group homes. Women and girls with disabilities also suffer up to three times greater risk of rape and are twice as likely to be survivors of domestic violence and other forms of gender-based violence (over a longer period and with more severe injuries) than women without disabilities.

The absence of appropriate sanitation facilities for girls with disabilities in schools, including separate, accessible, and sheltered toilets, in addition to the lack of education, resources, and support for menstrual hygiene, compromise their ability to properly manage their hygiene and make them especially prone to diseases. This often leads to girls and young women with disabilities staying at home or being sent to special schools. It can also lead to grave violations of rights such as forced hysterectomies or forced use of contraception that can eliminate or reduce menstruation.

Girls and young women with disabilities have the same sexual and reproductive health and rights as other girls and young women, as recognised in various internationally recognised conventions signed by many countries, for example, the Convention on the Rights of the Child (CRC), the Convention on the Elimination of all Forms of Discrimination Against Women (CEDAW), and the Convention on the Rights of Persons with Disabilities (CRPD), yet in practice, their needs are being overlooked or under-prioritised. This needs to change.

The situation for girls and women with disabilities only worsens in humanitarian settings – conflict and displacement exacerbate and heighten the discrimination that they already face in times of peace and destroy their protection systems, making them more vulnerable to exploitation. In such vulnerable situations, for example, girls and women with disabilities face increased levels of sexual and gender-based violence (GBV) in and out of the home, especially those with intellectual and mental disabilities.

Factors contributing to the lack of inclusion of women and girls with disabilities in humanitarian response include; gaps in policy development and implementation; negative attitudes of family members and communities; limited staff knowledge, attitudes, and practices; and lack of champions and local partners. 

My foundation – the Wellbeing Foundation Africa focuses on preventing birth injuries that may cause or lead to disabilities by improving maternal and child health from the very start. We emphasize and practice screening in order for preparedness, work with healthcare facilities to strengthen EmONC throughout Africa and the developing world and educate our mothers through the WBFA Mamacare360 flagship programme. We do this all while always practicing and preaching inclusion and accessibility of all. 

Universal access to EmONC is essential to reduce maternal mortality and requires that all pregnant women and newborns with complications have rapid access to well-functioning facilities that include a broad range of service delivery types and settings. We must ingrain this practice throughout Africa and rebuild the healthcare system. 

The 2030 Agenda for sustainable development is clear that disability cannot be a reason or criteria for lack of access to development programming and the realization of human rights. The SDGs include seven targets that explicitly refer to persons with disabilities. There is a need for an intersectional approach that empowers women and girls with disabilities and dedicates more resources and technical support, integrates innovative solutions, and develops guidance and practice which explicitly considers disability to create more enabling and accessible environments for persons with disabilities. Disability-related support services must also be classified as essential services. 

States must undertake long-term efforts to ensure the full respect, protection, and fulfillment of SRHR, the right to be free from violence, and related rights for women and girls with disabilities at all times. We need more data in this arena to support programme development. States need to prioritise the collection and dissemination of disability-related and disaggregated data and information to drive evidence-based programming and accountability. 

Adolescent girls with disabilities should be capacitated, empowered and meaningfully engaged in the development of all policies, programmes and legal processes that affect their health and well-being, which is one of the central tenets of PMNCH’s Adolescent Call to Action: https://www.adolescents2030.org/. We need to recognize that African culture hides disability, and therefore access to available basic needs becomes a problem. African Countries and policy makers must implement a One Health approach to tackle future pandemics and develop a system of support that provides a better platform for engagement with PWDs, to grant them more access to basic facilities in the country.

One Health is gaining recognition as an effective way to fight health issues at the human-animal-environment interface, including zoonotic diseases, as the approach recognizes how intertwined the health of people is with the health of animals, plants, and our shared environment. This collaborative, multisectoral, and transdisciplinary approach when implemented at the local, regional, national, and global levels can achieve the goal of optimal health outcomes which recognise the intrinsic connection between all living matters. 

Successful public health interventions require the cooperation of human, animal, and environmental health partners. Professionals in human health (doctors, nurses, public health practitioners, epidemiologists), animal health (veterinarians, paraprofessionals, agricultural workers), environment (ecologists, wildlife experts), and other areas of expertise need to communicate, collaborate on, and coordinate activities. Even law enforcement, policymakers, agriculture, communities, and pet owners are relevant players in a One Health approach. No one person, organization, or sector can address issues at the animal-human-environment interface alone.

To create a safer, more equitable future for our women and girls, we must advocate and put into action proactive and accessible policy which supports them from the get-go and not only when emergency situations arise. Through collective effort, we can create a sustainable tomorrow built upon and based on gender equality.