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Seeing the invisible: Sexuality-related knowledge, attitudes and behavior of children and youth with disabilities in China

SHANGHAI INSITITUTE OF PLANNED PARENTHOOD RESEARCH (SIPPR)
UNESCO
HUMANITY & INCLUSION (HI)
2019

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Young people with disabilities have the same right to Sexual and Reproductive Health (SRH) as their peers without disabilities, but their needs and rights are often overlooked. This study examines the SRH status of young people with disabilities in China. In particular, the study explored the sexuality-related knowledge, attitudes and behaviour of young people with disabilities as well as their access to sexuality-related information, education and services. The findings of the study are intended to provide evidence to support decision-making by government agencies, educators, development workers and other relevant stakeholders regarding developing and implementing disability-inclusive SRH and sexuality education policies and programmes for young people in China.

The study, using quantitative and qualitative methods, was conducted in 2015 among unmarried young persons aged 12 to 24 living with visual, hearing, physical and intellectual disabilities, in both urban and rural areas. The analysis was based on data collected through 707 completed valid questionnaires, 20 group interviews and 35 individual interviews with young people with disabilities, and individual interviews with 60 parents and teachers, along with one case study.

Everybody Matters: Good practices for inclusion of people with disabilities in sexual and reproductive health and rights programmes

Van SLOBBE, Caroline
November 2017

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This publication provides introductory chapters from two activists who work to create better opportunities for people with disabilities in Nigeria and India. Subsequently, the challenges that organisations worldwide have encountered whilst improving the access to and knowledge of sexual and reproductive health and rights for people with disabilities are presented. Ways in which they managed to find solutions and the results achieved are reviewed. Some cases show the importance of a more personal approach whilst others emphasise the advantage of changing systems and policies. Different regions, types of disabilities and various SRHR-topics are reflected in these stories. All cases provide lessons learnt that contribute to a set of recommendations for improved responses. The closing chapter highlights the challenges, solutions, and ambitions that are presented and lead up to a concise overview of recommendations.  

Good practice examples include:

A shift in SRH programming (Nepal)

Breaking Barriers with performance art (Kenya)

Her Body, Her Rights (Ethiopia)

People with disabilities leading the way (Israel Family Planning Association)

Best Wishes for safe motherhood (Nepal)

It’s my body! (Bangladesh)

Calling a spade a spade (Netherlands)

Four joining forces (Colombia)

Change agents with a disability (Zimbabwe)

Tito’s privacy and rights (Argentina)

Sign language for service providers (Kenya)

Sexual Abuse of Persons with Disabilities - Research

Rob Aley
et al
November 2016

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The aim of the research was to investigate the social, cultural and institutional factors which contribute to the high incidence of sexual abuse of persons with disabilities in East Africa and to identify interventions which could change detrimental attitudes, beliefs and practices which perpetuate this high incidence. The research is framed within the United Nations Convention on the Rights of Persons with Disability (UNCRPD), particularly articles 12, 13 and 16.

The study used a qualitative participatory action research approach and worked with local partner organisations and Ugandan and Kenyan field level researchers to collect data. Survivors of sexual abuse were not interviewed but instead the research investigated the understandings, beliefs and practices of a range of service providers and key responders who are involved in the prevention of and response to sexual abuse against persons with disabilities in their communities. Groups consulted included police, teachers, health-care workers, government administrators, faith and community organisations and traditional leaders, as well as persons with disabilities and their parents. Participatory workshops were run with a reference group of people with disabilities (with a range of impairments and experiences) and relevant specialists at the initial stage and during the participatory analysis process. After initial orientation and training the field researchers undertook a total of 52 individual interviews and 9 focus group discussions with a range of stakeholders.

The overall findings show that social attitudes and understanding of disability and sexuality in general are strong influencing factors on the risks that persons with disability face in relation to sexual abuse. Participants reported a range of harmful attitudes and beliefs about disability and about the needs and rights of persons with disabilities. It is very common for cases of abuse to go unreported and to be dealt with at the family or community level, rather than being viewed as a serious criminal matter which should be taken to the formal authorities. Many barriers exist, especially at community level which mean abuse does not get reported. Lack of awareness and knowledge, stigma and exclusion and poverty were key drivers of continuing abuse and survivors of abuse seldom get proper support. Guidelines, training and clear procedures for good practice in the various professions were generally weak or absent. Key recommendations were generated for both community level interventions and in relation to policy and training at regional and national levels. The practical implementation of some recommendations was undertaken.

Sexual Abuse of Persons with Disabilities - Research

ALEY, Rob
et al
November 2016

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Abstract
The aim of the research was to investigate the social, cultural and institutional factors which contribute to the high incidence of sexual abuse of persons with disabilities in East Africa and to identify interventions which could change detrimental attitudes, beliefs and practices which perpetuate this high incidence. The research is framed within the United Nations Convention on the Rights of Persons with Disability (UNCRPD), particularly articles 12, 13 and 16.

The study used a qualitative participatory action research approach and worked with local partner organisations and Ugandan and Kenyan field level researchers to collect data. Survivors of sexual abuse were not interviewed but instead the research investigated the understandings, beliefs and practices of a range of service providers and key responders who are involved in the prevention of and response to sexual abuse against persons with disabilities in their communities. Groups consulted included police, teachers, health-care workers, government administrators, faith and community organisations and traditional leaders, as well as persons with disabilities and their parents. Participatory workshops were run with a reference group of people with disabilities (with a range of impairments and experiences) and relevant specialists at the initial stage and during the participatory analysis process. After initial orientation and training the field researchers undertook a total of 52 individual interviews and 9 focus group discussions with a range of stakeholders.

The overall findings show that social attitudes and understanding of disability and sexuality in general are strong influencing factors on the risks that persons with disability face in relation to sexual abuse. Participants reported a range of harmful attitudes and beliefs about disability and about the needs and rights of persons with disabilities. It is very common for cases of abuse to go unreported and to be dealt with at the family or community level, rather than being viewed as a serious criminal matter which should be taken to the formal authorities. Many barriers exist, especially at community level which mean abuse does not get reported. Lack of awareness and knowledge, stigma and exclusion and poverty were key drivers of continuing abuse and survivors of abuse seldom get proper support. Guidelines, training and clear procedures for good practice in the various professions were generally weak or absent. Key recommendations were generated for both community level interventions and in relation to policy and training at regional and national levels. The practical implementation of some recommendations was undertaken.

HIV/AIDS in Haiti : key findings of the mortality, morbidity, and utilization of services survey : EMMUS-iv 2005-2006

MEASURE DHS (Demographic Health Surveys)
2008

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This report presents survey findings on HIV prevalence in Haiti and other related results, including knowledge of HIV and AIDS, attitudes toward people living with HIV, and sexual behaviour. The survey was undertaken by the Mortality, Morbidity, and Utilization of Services Assessment Survey (EMMUS-IV) [Enquête Mortalité, Morbidité et Utilisation des Services] conducted between October 2005 and June 2006. The French version of this report follows the English version

Women, harm reduction, and HIV

PINKHAM, Sophie
MALINOWSKA-SEMPRUCH, Kasia
September 2007

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This report looks at factors that reduce women drug users’ access to health care including punitive policies, discrimination by police and health care providers, the intense social stigma attached to drug use by women, a preponderance of harm reduction and drug treatment programmes directed primarily toward men, an absence of sexual and reproductive health services for drug users, and poor access to effective outpatient drug treatment. Pregnant drug users are particularly vulnerable. In too many instances, they receive little or no accurate information about drug use during pregnancy or prevention of mother-to-child transmission of HIV. In some countries pregnant drug users are rejected by health care providers, threatened with criminal penalties or loss of parental rights, or coerced into having an abortion or abandoning their newborns to the state. Poor access to medication-assisted treatment jeopardises the pregnancies of opiate-dependent drug users. It includes recommendations for consideration when designing services for women drug users and also examines issues around policies to protect women's health

UNAIDS expert consultation on behaviour change in the prevention of sexual transmission of HIV : highlights and recommendations

JOINT UNITED NATIONS PROGRAMME ON HIV/AIDS (UNAIDS)
2007

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This is the report of a two-day meeting to consider the state of knowledge around behaviour change measures for the prevention of the sexual transmission of HIV. Participants identified four priority issues around this: prevention measures that are effective in concentrated epidemics; analysis of and responses to sexual behaviour involving multiple concurrent partners and other hyperendemic scenarios; gender inequality, inter-generational sex and gender-based violence as major sources of vulnerablity to women and girls in hyperendemic scenarios; and HIV-related stigma and denial as barriers to behaviour change. Analyses of these issues produced a number of recommendations

School health activity guide

2007

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This kit provides teachers, peer supporters, and pupils with a guide that can help with ideas and suggestions on the kinds of activities that promote health, and ideas to encourage the creation and maintaining of a health club within their own school in line with the specific objectives of primary school education in Kenya

Engaging men and boys in changing gender-based inequity in health : evidence from programme interventions

BARKER, Gary
RICARDO, Christine
NASCIMENTO, Marcos
2007

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"This report seeks to fill a gap in the collective knowledge about engaging men and boys and to build on the three decades of experience in evaluating interventions to empower women and girls from a gender perspective....[It examines] the engagement of men and boys in programmes around sexual and reproductive health; HIV prevention, treatment, care and support; fatherhood; gender-based violence; maternal, newborn and child health; and gender socialisation"

Tell me more : children's rights and sexuality in the context of HIV/AIDS in Africa

THOMSEN, Sarah C
2007

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This report explores the strategies that children have developed for dealing with sexuality and relationships in the face of HIV and AIDS; and provides stakeholders with a coherent rights and youth-oriented knowledge base for the development of a sexual and reproductive health agenda for advocacy. It gives an overview of sexual rights with a focus on children’s rights, including their access to sexual and reproductive health information, as endorsed by relevant international conventions and policies. It also looks at the concept of sexuality and the sexual development of children. The report includes a summary of children’s reflections on issues of sexuality and their coping mechanisms for preventing the transmission of HIV and AIDS. Based on these findings, the report makes recommendations for effective responses that would support children’s existing coping mechanisms and enhance their ability to protect themselves

Responding to HIV & AIDS : Islamic resources and Muslim participation in Asia

ABDUS SABUR, M.
CHARNLEY, Simone
October 2006

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The paper then details some of the unique challenges encountered in combating the epidemic from an Islamic perspective, and how these dilemmas can be negotiated and rectified through the core values espoused by Islam in the Qur’an and Prophetic teachings. An illustration of how an Islamic perspective is being utilised to respond to HIV & AIDS is then provided through an outline of the work of the Asian Muslim Action Network (AMAN). It concludes with recommendations for future action in the area of faith-based responses to HIV & AIDS

Culture, religion and adolescent reproductive and sexual health [whole issue]

June 2006

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This issue reflects on how cultural and religious attitudes affect the sexual behaviour of young people and on the role they play in HIV incidence in the Asia-Pacific region. It also looks at good practices in this area. Includes two research briefs on the role of sex and HIV educational programmes for the youth and on knowledge and sexual behaviour of adolescent in Pune. Contains an interview with Halida Hanum Akhter, the recipient of the 2006 United Nations Population Award, which presents her insights into popular culture and reproductive health.

A client-centered approach to reproductive health : a trainer's manual

POPULATION COUNCIL
February 2005

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'The Population Council has developed a novel framework for training providers to deliver client-centered reproductive health services. The essence of the approach is to bring about behaviour change in providers by making them more receptive and responsive to client needs. Further, providers are taught to treat clients with respect and dignity, to assess their reproductive health needs holistically within the context of their household circumstances, and to negotiate solutions that clients are able to implement. Known by the acronym SAHR, this approach involves four interconnected steps: Salutation, Assessment, Help, and Reassurance. Through operations research, SAHR was successfully tested in Pakistan in 2000-02. The training manual describes the SAHR approach and is meant to facilitate training of reproductive health providers in how to offer client-centered services. The manual is written in fairly generic terms and can be used, with slight modifications, in any setting or country. The manual has three sections. Section One, the introduction, is an overview of the contents. Section Two, the trainer's guide, comprises the training modules. Each module describes the individual components of client-provider interaction and includes learning objectives, key learning points, a schedule, and a list of materials required. Trainer notes and step-by-step instructions for each activity are included within each module. Section Three contains support materials to help trainers prepare for the sessions.'

Impact of sex and HIV education programs on sexual behaviors of youth in developing and developed countries

KIRBY, Douglas
LARIS, B A
ROLLERI, Lori
2005

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This paper discusses findings from a review of 83 evaluations of sex and HIV education programmes. The analysis found substantial positive impact on sexual behaviours in more than two-thirds of the evaluations and identified 17 characteristics of the most effective curricula used in the programmes evaluated. More information on this review is available, including links to data sheets on each of the 83 evaluations. [Publisher's abstract, amended]

National household HIV prevalence and risk survey of South African children

BROOKS, Heather
SHISANA, Olive
RICHTER, Linda
2004

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This valuable new report looks at the levels of infection of HIV and AIDS, the levels of orphaning and child headed households, sexual debut and sexual experiences and risk factors and risk environments for children aged 2-14 in South Africa. This has been investigated as the HSRC recognizes that there is very little known about HIV prevalence rates among children or about the risk factors that predispose them to becoming infected. The study looks at the social and community risk factors that predispose children to HIV infection as well as the impact of the epidemic on children in terms of orphan status and child headed households. It examines children’s knowledge of HIV and AIDS prevention, their knowledge about sexual behaviour and HIV as well as their own patterns of sexual behaviour and changes in that behaviour. This study is interesting as it explicitly includes young children

Discrimination against women with disabilities

BELEZA, Maria Leonor
October 2003

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This publication highlights the difficulties that women with disabilities often encounter and includes practical information on how to improve their situation. The report analyses the underlying factors of double discrimination based on gender and disability and proposes concrete actions to achieve equality. This report would be of interest to all those concerned with the fight against discrimination throughout Europe

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