Accessibility of sexual and reproductive health services among women with motor disabilities in low- and middle-income countries in Africa: a systematic review.

Abstract

Background: Access to sexual and reproductive health (SRH) services is recognized as a fundamental human right and a core priority within global health agendas, particularly under the Sustainable Development Goals (SDGs). Despite significant legal advances such as the Convention on the Rights of Persons with Disabilities women with motor disabilities continue to face persistent marginalization, especially in low- and middle-income African countries. This systematic review aims to identify the barriers and facilitating factors influencing their access to SRH services.

Methods: Following PRISMA guidelines and registered with PROSPERO (CRD42024555816), this review adopted a Population, Concept, Context (PCC) search strategy. Studies published between 2001 and 2024 in English and French were retrieved from major electronic databases and grey literature sources. Data extraction and methodological assessment were conducted independently by multiple reviewers. A narrative synthesis was used for qualitative findings and a descriptive approach for quantitative data.

Results: Twenty-eight studies covering eleven African countries were included. The main barriers identified were grouped into five categories: physical and logistical constraints, social and attitudinal barriers, institutional limitations, economic hardships, and informational and communication barriers. Key facilitating factors included healthcare provider training, infrastructure adaptation, community mobilization, and the development of inclusive public health policies.

Conclusion: This review highlights the urgent need to embed disability inclusion within national SRH policies and to promote multisectoral strategies that address the systemic inequalities limiting access for women with motor disabilities.