A practice framework to improve accessibility of maternal healthcare services for women with disabilities in KwaZulu-Natal, South Africa

Abstract

Background Access to maternal healthcare services is a challenge in most low and middleincome countries. South Africa is one of the countries striving to improve the accessibility of maternal healthcare services. Although South Africa has put some interventions to improve the accessibility of maternal healthcare services, vulnerable women including women with disabilities are still facing numerous challenges when trying to access maternal healthcare services. Aim The aim of the study was to explore the factors that impact access to public maternal healthcare services for women with disabilities in KwaZulu-Natal with the ultimate goal of developing a practice framework to improve women with disabilities’ access to maternal healthcare services. Methodology An in-depth qualitative study was conducted using the case study method. Interviews and focus group discussions were used to collect data. Twelve women with disabilities (four with physical impairments, four with hearing impairments and four with visual impairments) were interviewed for this study. Focus group discussions were conducted with sixteen midwives and one-on-one interviews were conducted with four gynaecologists and one medical officer. Data were transcribed verbatim and analysed utilising the framework of assessing access to maternal healthcare services by Peters et al. 2008: 162. Findings Several factors impact access to maternal healthcare services for women with disabilities. They are classified into systemic, infrastructural and personal. These factors are interconnected to either positively or negatively impact access to maternal healthcare services for women with disabilities. Systemic factors include availability of human resources, training on handling pregnant women with disabilities and availability of sign language interpreters. Infrastructural factors include the design and layout of buildings, adjustable equipment, and assistive devices. Personal factors include attitudes of healthcare workers to pregnant women with disabilities, empowerment amongst women with disabilities, availability of a companion and the ability to read and write.