Sexual and reproductive health services for adolescents and young people with disabilities in Sub-Saharan Africa countries, 2013–2024: a scoping review

Abstract

Abstract

BACKGROUND: Adolescents and young people with disabilities (AYPWDs) face significant inequities in sexual and reproductive health (SRH) service utilisation. This scoping review maps available SRC service, utilisation rates, barriers, facilitators and service quality across sub-Saharan Africa (SSA) to inform inclusive police development. METHODS: This scoping review followed Arksey and O'Malley's methodological framework, and was reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis modified for-Scoping Reviews guidelines. Five electronic databases (PubMed, Scopus, Web of Science, CINAHL, and PsycINFO) were searched using predefined keywords and Boolean operators. Titles, abstracts, and full texts were screened independently using predefined eligibility criteria. Data from included studies were extracted using a structured form and synthesised using descriptive and thematic analysis. Studies published between January 2013 and August 2024 were included in this review. RESULTS: Sixteen studies were included. The studies took place in eight countries (greatest contributions from Ethiopia and Tanzania) with cross-sectional (56.25%), qualitative (25.00%), and mixed-methods (18.75%) study designs. The SRH services are grouped into prevention (family planning, STI/HIV prevention), care/treatment (maternal services, STI/HIV care), counselling/education (comprehensive sex education, counselling), and support services (GBV counselling, psychosocial support). Utilisation ranged from low to moderate, where assessed. Stigma/discrimination, negative provider attitudes, communication barriers (including the absence of sign language and adapted materials), inaccessibility, and weak confidentiality/privacy were the most frequently reported barriers. Key facilitators included education on reproductive health, peer and family support, positive provider attitudes, facility location, and sensitive communication with YPWD. Service quality was most commonly reported as poor, with limited privacy, long waiting times, and inadequate adaptation to be inclusive of people with disability. CONCLUSION: Maximising disability inclusion of the country's SRH policy and plans and Health system strengthening in consonance with the CRPD and the 2030 Sustainable Development Agenda is key to making equitable access a reality and to address structural and attitudinal barriers by building the capacity of providers, delivering services that are responsive to the needs of persons with disabilities, and making facilities and information progressively more accessible.