Nothing About Us, Without Us: Improving SRHR access for persons with disabilities in Rwanda

Learn how Troupe des personnes Handicapés Twuzuzanye (THT) in Rwanda are advocating for improved policy and law reform on disability and SRHR.

Globally, persons with disabilities, particularly women and girls, face substantial barriers in accessing sexual and reproductive health and rights (SRHR). Discrimination, stigma, and negative cultural beliefs about persons with disabilities and their sexuality means individuals struggle to access information. A lack of inclusive resources, infrastructure, materials, and training for healthcare staff on the needs of persons with disabilities act as barriers to access services. Disability is often left out of national policy and law, making implementation of these laws to meet the needs of persons with disabilities more challenging.

However, AmplifyChange grantee partners are working tirelessly to change this situation in their contexts.

Troupe des personnes Handicapés Twuzuzanye (THT), a Strengthening grantee partner, is a self-led organisation for persons with disabilities founded in 2004 and registered in 2009 in Rwanda. Its mission is to advocate for disability rights through socio-cultural activities and community-based behaviour change. THT is one of the eight organizations that came together in 2010 to create the umbrella organisation National Union of Disabilities’ Organisations of Rwanda (NUDOR). THT work at the intersection of the SRHR and disability rights movements, making them well placed to advocate for change in these sectors.

After three years of campaigning, THT and their coalition partners successfully mainstreamed disability access and rights into the National Family Planning Guidelines and Standards for Rwanda. THT was a member of the national family planning and SRHR technical working groups who provided technical assistance in the development of the National Family Planning Guidelines and Standards. The working groups brought together UN agencies, government agencies, civil society, and professional bodies. The success of integrating disability, including tailored measures, into the family planning guidelines is a milestone for ensuring access to inclusive SRHR services for all in Rwanda.

The guidelines, published March 2022, led to a notable shift in SRHR service providers’ awareness and desire to become more inclusive in their work, such as an increase in requests for training on sign language. However, there is still work to be done to ensure that service providers have adequate skills to effectively implement the new guidelines.

To facilitate this work, through their AmplifyChange project, THT has

• trained more than 129 healthcare staff from four districts on topics including Disability Equality Training, the legal framework for the rights of persons with disabilities, the realities of accessing SRHR services from the perspective of a person with disability, and an introduction to sign language. THT have been contacted by two other districts to do the same trainings;
• monitored an improvement in service provision for persons with disabilities and an increased commitment to disability mainstreaming in more than 20 health centres since 2019; and
• reviewed the availability and content of partner health centres’ action plans for the 2022-2023 fiscal year, with most health centres at both district and national level including provisions to improve access to services for persons with disabilities.

National-level advocacy to improve standards and guidelines for SRHR care for persons with disabilities is ongoing. THT resumed their participation in national family planning and SRHR working groups and pushed for follow-up meetings after the family planning guidelines and standards were adopted.

To date, there are further successes in mainstreaming disability rights into the revision process for a number of government policies and guidelines. THT and their partners are involved in the development of these guidelines as members of technical working groups for adolescent sexual and reproductive health (ASRH) and family planning at the national level:

• The ASRH guidelines are under development and are inclusive of persons with disabilities.
• The revision process for the 2018-2024 Reproductive, Maternal, Newborn, Child and Adolescent Health (RMNCAH) policy has started. THT will advocate to ensure that disability is mainstreamed throughout this policy and include objectives around improving access to SRHR services.
• The law protecting persons with disabilities is under review, with THT participating in the process. Notably, the section on health is aiming to integrate disaggregated data by types of disabilities using the Washington Group Short Set of Questions. Disaggregated data will be an important leverage for advocacy campaigns led by the THT and their coalition.

THT demonstrate how intersectional movement building and partnerships can result in incredible successes. By ensuring that persons with disabilities and their needs are included in government policies, civil society organisations and their partners can achieve further advocacy, implementation, and training. In mainstreaming disability rights into SRHR policy and law, better SRHR service provision and social norm change around disability and sexuality can follow. These improvements will better the livelihoods of persons with disabilities across Rwanda.

AmplifyChange founding member Hon. Safia Nalule Juuko speaks about the importance of ensuring SRHR for women and girls with disabilities in this blog.

Read more in our How To guides about improving access to SRHR for persons with disabilities on AmplifyChange Learn.