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Women’s Integrated Sexual Health (WISH) Programme for Results: independent verification, evidence, and learning

An evidence gap map on ‘what works’ to ensure persons with disabilities have access to sexual reproductive health services in low and middle-income countries.

As part of the Department for International Development’s (DFID’s) Women’s Integrated Sexual Reproductive Health (WISH) programme, an evidence gap map (EGM) has been developed to map interventions on ‘what works’ to enable access to sexual reproductive health (SRH) services for persons with disabilities in low and middle-income countries (LMICs). EGMs are a user-friendly presentation of the available, relevant evidence for a particular sector, which is systematically gathered and mapped onto a framework, visually highlighting the gaps or concentration of evidence. This EGM aims to support WISH programming by consolidating evidence and identifying tools/approaches which could be brought into the programme. In addition, it aims to identify where evidence is weak and how the WISH programme can contribute to evidence generation.

It is estimated that persons with disabilities make up 15% of the world’s population (WHO, 2011). A growing body of evidence shows that persons with disabilities have historically been denied their SRH rights, despite having the same sexual needs as people without disabilities, and continue to face many barriers to accessing SRH services (Carew et al, 2017; Apolot, 2019). The WISH programme (hereafter ‘WISH’) is a flagship, multi-country SRH initiative that aims to benefit a significant number of women living in LMICs in line with DFID’s commitment to ‘leave no one behind.’ WISH has four key thematic focus areas, one of which is reaching persons with disabilities. As such, the WISH consortium includes several disability-focused partners and the programme works with persons with a disability in a variety of ways.

In 2018, DFID commissioned an EGM to assess the effectiveness of interventions for persons with disabilities in LMICs in relation to education, health, jobs and livelihoods (White, Saran and Kuper, 2018). However, this did not include an in-depth look at the evidence available on access to SRH services. Fraser and Corby (2019) highlighted this in their report ‘Family Planning for Women and Girls with Disabilities,’ as did Carew et al (2017), stating that ‘…where there has been some attention to disability and sexual health, it has tended to focus predominantly on vulnerabilities, and we need to know much more about emancipatory practices.’ To address this gap and to support WISH countries with their programmes, this EGM focuses on which interventions work.

This report provides a written accompaniment to the EGM to explain the methodology, findings on the availability of evidence, and key recommendations. When scoping for this EGM, it was recognised early on that some of the best practices and interventions on ‘what works’ to support persons with disabilities access SRH services in LMICs are not always empirically tested. Therefore, a decision was made to develop an EGM which includes both peer-reviewed and grey literature. This approach diverges from the norm, as EGMs typically only include peer-reviewed literature.