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Disability and Access to Sexual and Reproductive Health Services in Cameroon: A Mediation Analysis of the Role of Socioeconomic Factors

1
Centre Etude en Population (CEPED), Institut de Recherche pour le Développement, Université Paris Descartes, INSERM 1244, 75006 Paris, France
2
Institut de Formation et de Recherche Démographiques (IFORD), Yaounde BP1556, Cameroon
3
Expertise France—5% Initiative for HIV, Malaria and TB, 75006 Paris, France
4
School of Public Health, University of Montreal, Montreal, QC H3N 1X9, Canada
5
Humanity & Inclusion, 69371 Lyon, France
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2019, 16(3), 417; https://doi.org/10.3390/ijerph16030417
Received: 22 November 2018 / Revised: 19 January 2019 / Accepted: 24 January 2019 / Published: 1 February 2019
(This article belongs to the Special Issue Disability and Global Health)
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Abstract

There is growing evidence showing that people with disabilities face more frequently socioeconomic inequities than their non-disabled peers. This study aims to examine to what extent socioeconomic consequences of disability contribute to poorer access to sexual and reproductive health (SRH) services for Cameroonian with disabilities and how these outcomes vary with disabilities characteristics and gender. It uses data from a population-based survey conducted in 2015 in Yaounde, Cameroon. Mediation analysis was performed to determine how much of the total association between disability and the use, satisfaction and difficulties to access SRH services was mediated by education level, material wellbeing lifetime work participation and availability of social support. Overall, disability was associated with deprivation for all socioeconomic factors assessed though significant variation with the nature and severity of the functional limitations was observed. Lower education level and restricted lifetime work mediated a large part of the association between disability and lower use of HIV testing and of family planning. By contrast, while people with disabilities reported more difficulties to use a SRH service, no mediating was identified. In conclusion, Cameroonians with disabilities since childhood have restricted access to SRH services resulting from socioeconomic factors occurring early during the life-course. View Full-Text
Keywords: disability; sexual and reproductive health; access to health services; Sub-Saharan Africa; mediation analysis; epidemiology disability; sexual and reproductive health; access to health services; Sub-Saharan Africa; mediation analysis; epidemiology
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DeBeaudrap, P.; Mouté, C.; Pasquier, E.; Mac-Seing, M.; Mukangwije, P.U.; Beninguisse, G. Disability and Access to Sexual and Reproductive Health Services in Cameroon: A Mediation Analysis of the Role of Socioeconomic Factors. Int. J. Environ. Res. Public Health 2019, 16, 417.

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