The Intersectional Influence of Disability and Gender in Health-Seeking for Sexual and Reproductive Health in Bangladesh: A Mixed Methods Nationwide Study

This chapter highlights the intricate terrain of sexual and reproductive health (SRH) challenges encountered by persons with disabilities in Bangladesh, as well as their coping and healthcare-seeking behaviors to address these challenges. The chapter draws on data from a nationally representative survey in 2019, which includes 1954 ever-married persons with disabilities (1239 men and 715 women), along with 14 qualitative interviews. About 30% of the men and 15% of the women reported that disability had an impact on their intimate relationships, and the primary concern for both sexes was that their partners would not find them attractive because of their disability. There were gender differences in the proportion reporting any SRH symptom and the ways healthcare was sought from different types of healthcare providers. Significantly more women than men reported experiencing a sexual or reproductive health problem in their lifetime (64% vs. 45%), and during the last 12 months preceding the survey (56% vs. 35%). Approximately one-third (32.4%) of the men and 43.7% of the women with an SRH symptom sought any healthcare, mainly from informal healthcare providers. Qualitative information delves into the challenges that individuals with disabilities face in relationships,  highlighting how disability, societal perceptions, and relationship dynamics differentially impact women and men. Addressing the various issues affecting the SRH experiences and healthcare access of persons with disabilities in Bangladesh calls for multifaceted strategies. These strategies should include gender-sensitive SRH education, stigma-reduction campaigns, inclusive and confidential healthcare spaces with open communication, and targeted financial assistance programs, especially in rural and economically disadvantaged areas.