TITLE:
Reproductive health needs of physical handicapped females in Kinshasa, DR Congo
AUTHORS:
Tandu-Umba Barthélémy, Sukama Tandu Yves
KEYWORDS:
Sex and Reproduction; Disabled Women in Kinshasa; Psycho-Social Limitations
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.3 No.1A,
February
5,
2013
ABSTRACT:
Objective: Our study is intended to evaluate mobility impairment’s level in adult females, their sociodemographic status, knowledge, and practices related to reproductive health in order to provide healthcare givers and policy makers with tools to meet appropriate needs of these vulnerable persons in Kinshasa, DR Congo. Study design: A cross-sectional descriptive study from March 20th 2012 throughout July 20th 2012 concerned 138 physical (non mental) disabled attendees of 7 centers for disabled adults in Kinshasa, DR Congo. Concerns about extend of the disability focused on parts of the body concerned, functional capacity (self walking, crutches, prosthesis, wheel-chairs) and manual freedom. Participants were interviewed using open-ended questions about sociodemographic status, knowledge, and practices related to reproductive health. Issues concerned included age at menarche, age at first sex experience, marital status, education level, employment status, obstetric history, sex abuse, birth control and sexual transmitted diseases. For statistic analysis OR (CI at 95%) was calculated to seek for possible association between physical impairment and parturition’s characteristics. Results: The mean age of the study group (31.1 ± 5.7 years) ranged from 15 to 40 years. Most were affected by legs and the majority (69.1%) needed crutches or wheelchair for moving. Only 21 (15.2%) were married, most (15) of them with a disabled colleague. Mean parity and gravidity were 2.78 ± 2.3 (range 0 - 11) and 3.4 ± 2.5 (range 0 - 12), respectively. Sex experience was initiated at 17.5 ± 3.7 years (range of 12 - 35), 13 (9.4%) had experienced rape, and 37 (26.8%) had (illegally) aborted. Of the 117 women who had had a child 82 (70.7%) had vaginal delivery. In 24 of 34 cesarean sections fetopelvic disproportion or protracted pelvis was the main indication (68.6%), the risk for cesarean section being somewhat related to involvement of 2 legs. Data concerning the issue of knowledge and practices related to reproductive health were very limited and unreliable. Conclusion: Based on the age at menarche, at first intercourse and having had child reflect obvious interest of disabled in sex and reproduction, even if unmarried. Their limited information on reproductive health education results in unplanned pregnancy, unsafe abortion and risk for HIV and other sexual transmitted diseases. The rate of vaginal delivery is likely to redeem own perception on their health status. This could be basis for adhesion to specific programs devoted to physical, psychological, and social limitations.