Volume 7, Issue 12, December – 2022 International Journal of Innovative Science and Research Technology

ISSN No:-2456-2165

Barriers Affecting Students with Special Needs in

Accessing Comprehensive Sexual and Reproductive
Health Services and Rights on Campus a Case of
Kwame Nkrumah University
Misheck Samakao
Kwame Nkrumah University

Abstract:- Students with special needs face a lot Table of Acronyms

obstacles during their studies on campus. In many CSRH: Comprehensive Sexual and Reproductive Health
institutions of higher learning there is often little PEP: Post –Exposure Prophylaxis
attention given in the provision of the services with HIV: Human Immunodeficiency virus
respect to students living with disabilities. Students with AIDS: Acquired immunodeficiency syndrome
special needs are 3-4 times at higher risks of contracting SNE: Students with Special Needs
HIV/AIDS as compared to the ordinary students. The AU: African Union
institutions of higher learning mostly do not take this KNU: Kwame Nkrumah university
reality into consideration in terms of planning and MOH: Ministry of Health
repackaging of services in order to meet this challenge. HEI: Higher education Institution

Students with special needs suffer gross violation of I. INTRODUCTION

human rights during their period of study in institutions
of higher education leading to high levels of stigma, high Universities are known to be places of high levels of
exposure to HIV/AIDS risks, high unhygienic conditions freedom with students experiencing high levels of
and poor sanitary services, lack of attention and even civilization. With the African Agenda of 2063 providing
denial of access to health, sexual and reproductive health free access to comprehensive sexual and reproductive health
services on campus both directly and indirectly. services to all youths in society, there appears to be a big
challenge with respect to accessibility and availability for
The study used qualitative research methodology. comprehensive sexual and reproductive health for students
Both probabilistic and non-probability techniques were with special needs (Obasi et al, 2019). Students with special
used as sampling techniques. needs are also human beings with feelings just like any other
including sexual desires. In fact, they have even more
The findings of the study showed that students complicated limitations. When it comes to sexual drives, it
living with disabilities had difficulties in accessing becomes very difficult to fully socialise and get the services
comprehensive sexual and reproductive health(CSRH) they need through peer interaction. This is because they face
services. They reported long distances to the facility, stigma and isolations from the rest of the student’s
stigma, negative attitudes from medical staff including community and their peer. However, sometimes it is the
communication barriers and myths. medical personnel who would subject them to long queues,
lack of confidentiality and failure to exercise courtesy and
It was recommended that comprehensive sexual privacy, including serious language and communication
and reproductive health services need to be repackaged barriers (Karimu 2017).
effectively in order to meet the demand from students
living with disabilities on campus. There was also need to In universities and colleges, students with special
create more robust awareness and sensitization needs have suffered many limitations with respect to
programs to specifically address challenges faced by accessibility and availability of comprehensive sexual and
students with special needs. The study contributed to the reproductive health services, thereby leading to high sexual
body of empirical knowledge relevant to policy makers, risky behaviour and increasing their exposure to infections
academicians and planners in the fight of HIV/AIDS of diseases and unwanted pregnancies (Burke et al. 2017).
pandemic.
A. Statement of Problem
Keywords:- Comprehensive Reproductive Health, Students with special needs have had challenges in
Disability, Students with Special Needs, Accessibility, accessing their sexual and reproductive health services on
Availability, HIV/AIDS, Vulnerability, Barriers. campus. They face amongst other factors, stigma, lack of
information, language barriers, lack of privacy and
sometimes long queues and shortages of the stock

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Volume 7, Issue 12, December – 2022 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
(Abdurahman et al. 2022). Despite the university being the order to get a full view of the phenomenon under
centre of civilization, it has continued to record high HIV investigations. The research sample included the following;
risks cases as the students with special need are increasing students (30) health workers (3) administrative staff (2)
in population but still cannot get what they need. If this academic staff (2) organisation with disabilities (1) and the
situation is not addressed, Students witjh special needs total shall be 38.
(SNE) will be highly exposed to human immunodeficiency
virus/acquired immunodeficiency syndrome(HIV/AIDS) B. Ethical Considerations
and other sexually transmitted Infections (STIs) as they have The study took into account the ethical requirements in
limited access to the Comprehensive Sexual Reproductive its process. The application was submitted to the research
Health services on campus. Since SNE are already and ethical committee at Kwame Nkrumah University to
vulnerable, this situation if left unchecked might lead to seek for clearance of the study prior to the actual
high pregnancy rates and high HIV/AIDS infections rates undertakings. The clearance was given and the consent were
sought from all research participants that took part in the
B. Objectives study accordingly.
 To establish the availability of CSRH services on
campus for students living with disabilities. IV. REVIEW FINDINGS
 To assess levels of awareness of the CSRH amongst
students living with disabilities A. Levels of awareness Amongst Students Living with
 To ascertain levels of accessibility to CSRH affecting Disabilities
students with special needs on campus The findings of the study indicate that slightly above
 To ascertain the barriers affecting students with special half (58%) of the respondents were aware about the
needs in accessing CSRH on campus availability of the compressive sexual and reproductive
 To determine measures that could mitigate the barriers health on campus. The rest (42%) were not aware of the
affecting students with special needs in accessing service. From the number that was aware of the availability
Comprehensive Sexual Reproductive Health Services on of the service, some also indicated knowledge of condoms,
campus. counselling and testing but they expressed ignorance about
the availability of post-exposure prophylaxis (PEP), and
II. SIGNIFICANCE OF THE STUDY other related services. However, when further asked about
the reliability of the services on campus, the majority of
This study is very critical as it shall help SNE to have those who accessed them indicated the services were very
access to CSRH services on campus. It shall also create reliable. Further, it can be observed many respondents
awareness and enhance planning for the effective provision indicated that the quality was also good in term of the
of health care services to students with special need. Above conditions of the products and services that they received.
all, this study is basically going to help ensure prevention of
unwanted pregnancies and also prevention of sexually B. Barriers in accessing Comprehensive sexual and
transmitted diseases from the students living with reproductive health
disabilities. Furthermore, planners, policy makers and health The most common barriers that respondents indicated
care providers will be empowered to repackage their included the myths, privacy, distance and staff attitudes
services to executively provide additional help to SNEs on towards students with special needs. Of the barriers
campus. mentioned the myths and staff attitudes ranked in the first
and second positions while privacy and distance followed
III. RESEARCH METHODOLOGY respectively. The majority of the students living with
disabilities mentioned that they had difficulties in accessing
The study used qualitative research methodology. An the services from the clinic on the basis of the trading myths
in-depth explorative view was used to explore, describe and and the negative staff attitudes as well as the common
explain the phenomenon under investigation through the practice of recording details when they accessed
sharing of experiences, values and opinions. The study was contraceptives which they felt was an infringement on their
anchored on phenomelogical philosophical perspective as it rights of privacy.
focused on real life situation searching for human
experiences in a normal environmental setup. C. Levels of HIV/AIDS exposure and risk behaviour
amongst SNE students
A. Sampling, Data Collection and Analysis The findings of the further revealed that the students
The sample size used was 38 and it comprised of with special needs had high pressure with regards to sexual
students with special needs, health care providers, academic demands from the student’s community. They indicated that
staff and administrative staff. The data was collected using the most form of disabilities under high attack included
the semi-structured questionnaires and interview guides. It students living with albinism where the majority of students
further engaged focused group discussions with SNEs and were trying to experiment how sex feels with someone
special interviews with both administrators and the care living with albinism. The majority mentioned that they were
providers. The study sample was collected using both approached on the daily basis for sexual favours with all
probability and non-probabilistic methods called purposive sorts of temptations and allurements. The majority of the
sampling and random sampling techniques respectively in in rest indicated that they still had very high sexual feelings

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 Volume 7, Issue 12, December – 2022 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
and they needed enough protection against the spread of B. Barriers affecting accessing of CSRH for students living
diseases and other sexually transmitted infections. One of with disabilities
the respondents interviewed indicated that they were asked Amongst the critical barriers exposed in the study are
that where do you take condoms when you get them from myths. The majority of the university community believe
the clinic? Another students living with albinism was asked that students living with disabilities do not have sexual
as to why she wanted condoms and when she went back in feelings and as such they are not expected to seek for family
the same week, the care provider quizzed her loudly “you planning services or any other related services. Similarly,
again?” the majority of students have indicated that even care
providers show visible sign of surprise whenever they would
D. Measures to mitigate factors that lead to high sexual risk see a person living with disabilities coming to access
behaviour among SNE condoms or related services. This mystical misconception
When students with special needs were interviewed as that students living with disabilities are not expected to have
to what could be the solution towards the challenges being sex makes a lot of them avoid seeking services from the
faced with respect to accessibility they indicated that they clinic, but resort to either buy at times in remote places. On
needed management interventions in order to have the average a student struggles with the problem of money and
problem addressed. They further stated there was a need to as such it becomes very difficult if they are not able to get
create awareness and sensitization against the availability of what they need which they think is useful within walkable
CSRH products across the campus. This they indicated distances but rather board a taxi to go and look for condoms
would help to change the staff attitudes and practices in whose cost is less than the cost of boarding bus or taxi. This
order to address the barriers. situation might put a lot on them on high risk as they might
resolve to use unprotected sex.
V. DISCUSSION OF THE RESEARCH FINDINGS
Secondly, there are negative attitudes held by the care
A. Levels of Awareness providers on campus with respect to students living with
It has been observed that the levels the awareness on disabilities. Most care providers have challenges when
comprehensive sexual and reproductive health amongst dealing with students with special needs, For instance there
students living with disabilities are very low. The majority is communication breakdown as they always need a
do not know about all the services that could be possibly translator who might not be readily available.
available on campus for the purposes of HIV/AIDS
prevention. The low awareness levels have great potential to Furthermore, it has been mentioned that there are still
cause high HIV/AIDS risks and related complications such challenges with privacy of the clinic. The location of the
as unwanted pregnancies amongst students with special clinic is situated very close to female hostels on campus.
needs. The low awareness levels were attributed to the fact This in essence makes it hard for the male students to seek a
there were already communication barriers existing between service as they would be seen by the female students and
the students with hearing impairments, the blind and the easily being suspected of being sick. This prevents a big
dumb. This makes all efforts of awareness difficulty on number of male students from getting health services from
campus unless the information is repackaged differently. the university clinic. Further, a sizable percentage of
This could pose a danger in terms of possible HIV/AIDS students most of whom with vision impairments also
risks and unwanted pregnancies because all the students are complained of long distance from the rooms to the location
of reproductive age and indicated that they were already of the clinic. This is understandably clear when one
sexually active. The population of the students living with considers the visually impaired students who always need an
disabilities is increasing daily on campus and this could assistant in order to move from one area of the campus to
further lead to more complications with respect to the spread the next one. There is need therefore to find a way to solve
of the disease if no extra efforts are invested to curtail the the problem of distance as well. The limitation and the
unpleasant ordeals on campus. There is need to keep stock finding of this study are exactly in line with what Loope
of the contraceptives readily available for higher (2011) found out in his study that distance, negative staff
accessibility to all students living with disabilities on attitudes and communication barriers are main challenges
campus. This finding is in line with the findings of Scarvey faced by students living with disabilities in accessing the
(2017) who clearly indicated in his research work that most medical health care especially CRSH on campus. Calibre
students living with disabilities find it hard to access the (2021) also stated that these problems on paper look trivial
CSRH on campus due the nature of natural limitations but they are serious when one considers the state of the
existing with them. His counterpart Cadley(2021) further students with special needs. In view of this therefore Charity
argued that accessibility is not easy with respect to students (2020) recommended that special attention must be invested
with special needs and as such the care providers must in the way services are packaged for the sake of the students
always go an extra mile in order to close this gap. There is with special needs on campus.
need for example to repackage the products as suggested by
Muller (2019) that information on CSRH must be packed in
formats that would reach the students with special needs in a
special manner otherwise they would remain on the higher
risk exposure of being susceptible to HIV/AIDS scourge and
other related problems.

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Volume 7, Issue 12, December – 2022 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
C. Levels of HIV/AIDS exposure and risks towards the VI. CONCLUSION
pandemic
The population of students living with disabilities is Students living with disabilities are at a higher risk
highly as risk when it comes to Sexual risk behaviour from spreading of the HIV/AIDS pandemic on campus.
because of peer pressure coming from ordinary students They face more challenges with respect to peer pressure,
whose population is so high. For example, students want to limited resources, long distances to the health facility, long
experiment especially on the students living with albinism. queue, negative attitudes from caregivers and also
The majority of the students are always looking for information and language barriers. Since, students living
opportunities to get sexual experience with someone living with disabilities are of reproductive age and also sexually
with disabilities and as such they too have much pressure active, it is important that extra efforts be invested in
coming from student’s community with all sorts of repackaging the programs that aim at reaching this minority
attractions to lure the students living with disabilities to fall group on campus in the most efficient and effective way.
for the presents and classified gifts in exchange for sexual
favours. Some students with special needs may not There is also need to identify some students from the
continuously resist the temptations and this is more reason hostels to be trained as peer educators and also as focal point
why they need contraceptives in order to prevent the spread persons with information and products well repackaged to
of diseases as well the unwanted pregnancies. The findings serve students living with disabilities on campus.
of this study are in tandem with the findings from another
study conducted by Chally (2021) that showed that students ACKNOWLEDGMENTS
with disabilities are a minority compared with the rest of the
ordinary students and they may be at high risk in such an It is my privilege and honour to take this opportunity to
environment that has high numbers of students who might acknowledge specific people that massively made sacrifices
already be sexually active. to contribute to this project immensely. Firstly, I wish to
acknowledge Janet Chitsino a final year student for being
D. Proposed measures to mitigate the spread of HIV/AIDS instrumental in her duties as research assistant and also
amongst students living with disabilities. facilitator and link to the group of students with various
It was highly recommended that for the highlighted special needs. She also provided transcribing services and
barriers above there is need to create awareness and interpretation of sign language during some tedious
sensitization campaigns in order to mitigate the information interviews that cost us a lot of resources and time.
gaps that are currently prevailing on campus. Information
must be repackaged to suit the specific users that include  Special thanks again go to Ms Natasha Mulenga for
students with hard hearing, those with visual impairment being committed and consistent in the organisations of
and those with hard speech. Specific information must be research schedules and logistics, before during and after
tailored to reach the students with special need on campus. the study.
Further special programs must be created pre-tailored to  I wish to thank also Mrs Doreen Chilombo an ardent and
target the care-givers with knowledge and communication veteran psychosocial counsellor and mentor for
sign language skills so that they are able to attend to the provision of support and consistent collaboration in the
students with special need without much difficulties. process of data collection and insights in the
Besides they must also be sensitized against having negative coordination of key stakeholders.
attitudes towards this section of the campus grouping. They  I wish also to take this chance to commend my family
need to be extra careful so that whatever they say or do is for the support and mutual encouragements before,
not wrongly interpreted. during and after the project. My son kisu and my
daughter hope were ever on point to render the much
Additionally, more funding is required in order to needed moral support. Despite the late hours of
enable the students with special needs to have improved investment into this project they never gave up on me
services of CSRH stocked in many other strategic points for but instead continued to rally behind me at all times.
easier accessibility at all cost. For example, in each block of  Furthermore, I wish to also recognise Kwame Nkrumah
hotels where they stay, one student need to be trained as university management for giving us the permission to
peer counsellor so that they could act as strategic point for proceed with the study. My current employer, Kwame
effective distribution of condoms and other specific Nkrumah university had trust and confidence in making
services. it possible for me and my team to engage in this research
work at such a difficulty time when the university was
Moreover, it also strongly recommended that the very busy with a lot of equally important assignments
university must provide enough rooms to be able to offer across the lifeline of the university business.
effective counselling services for both genders males and  Most importantly. I give all the glory and praise to the
females respectively. Lord God Almighty, the creator of the heavens and
earth, who has been my guide and source of strength for
the blessing and special favour endowed upon me and
my team to run this race successfully.

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ISSN No:-2456-2165
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