La invisibilidad en el sistema sanitario - Barreras y desafíos en la atención ginecológica para mujeres con discapacidad

Autores/as

DOI:

https://doi.org/10.26754/ojs_ais/accionesinvestigsoc.20254611108

Palabras clave:

discapacidad, género, salud reproductiva, derechos sexuales

Resumen

Introducción: La intersección entre género y discapacidad ha emergido como un área crucial de estudio, evidenciando la doble discriminación que enfrentan las mujeres con discapacidad, particularmente en el ámbito de la salud ginecológica. Esta problemática requiere de una atención prioritaria desde el trabajo social y la salud pública. En este contexto, el objetivo principal de este trabajo es analizar las barreras que enfrentan las mujeres con discapacidad en el acceso a servicios de salud ginecológica, explorando la intersección entre género y discapacidad.

Material y métodos: Se realizó una revisión bibliográfica sistemática siguiendo las directrices PRISMA. Se incluyeron estudios en inglés, español o portugués, que abordaran la atención ginecológica o salud reproductiva de mujeres con discapacidad. Los estudios debían ser empíricos, revisiones sistemáticas o metaanálisis, excluyendo aquellos sobre discapacidades temporales, sin datos empíricos originales o centrados únicamente en aspectos pediátricos.

Resultados: Los estudios identificaron múltiples barreras a nivel nacional, del sistema de salud, individual, comunitario y económico, que restringen el acceso de las personas con discapacidad a servicios de salud ginecológica y reproductiva, especialmente en países de ingresos bajos y medios. Destacan las actitudes negativas, el estigma y la discriminación hacia la sexualidad y maternidad de este colectivo.

Discusión: Frente a este panorama, los estudios proponen estrategias multinivel centradas en la transformación de los sistemas de salud, la capacitación de proveedores, la mejora de la accesibilidad, el empoderamiento de las personas con discapacidad y la sensibilización comunitaria, enmarcadas en el respeto a los derechos humanos.

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Referencias

Addlakha, R., Price, J., & Heidari, S. (2017). Disability and sexuality: claiming sexual and reproductive rights. Reproductive Health Matters, 25(50), 4-9. https://doi.org/10.1080/09688080.2017.1336375 DOI: https://doi.org/10.1080/09688080.2017.1336375

Bright, T., Wallace, S., & Kuper, H. (2018). A systematic review of access to rehabilitation for people with disabilities in low-and middle-income countries. International journal of environmental research and public health, 15(10), 2165. DOI: https://doi.org/10.3390/ijerph15102165

https://doi.org/10.3390/ijerph15102165

Casebolt, M. T. (2020). Barriers to reproductive health services for women with disability in low-and middle-income countries: a review of the literature. Sexual & Reproductive Healthcare, 24, 100485. https://doi.org/10.1016/j.srhc.2020.100485 DOI: https://doi.org/10.1016/j.srhc.2020.100485

Crenshaw, K. (2013). Demarginalizing the intersection of race and sex: A black feminist critique of antidiscrimination doctrine, feminist theory and antiracist politics. In Feminist legal theories (pp. 23-51). Routledge.

Devine, A., Ignacio, R., Prenter, K., Temminghoff, L., Gill-Atkinson, L., Zayas, J., ... & Vaughan, C. (2017). “Freedom to go where I want”: improving access to sexual and reproductive health for women with disabilities in the Philippines. Reproductive health matters, 25(50), 55-65. https://doi.org/10.1080/09688080.2017.1319732 DOI: https://doi.org/10.1080/09688080.2017.1319732

Dominelli, L. (2017). Feminist social work theory and practice. Bloomsbury Publishing. DOI: https://doi.org/10.4324/9781315183213-2

Esmail, S., Darry, K., Walter, A., & Knupp, H. (2010). Attitudes and perceptions towards disability and sexuality. Disability and rehabilitation, 32(14), 1148-1155. https://doi.org/10.3109/09638280903419277 DOI: https://doi.org/10.3109/09638280903419277

Flynn, E. (2016). Disabled justice: Access to justice and the UN Convention on the Rights of Persons with Disabilities. Routledge. DOI: https://doi.org/10.1007/978-3-319-43790-3_17

Frohmader, C., & Ortoleva, S. (2014). The sexual and reproductive rights of women and girls with disabilities. In ICPD International Conference on Population and Development Beyond.

Gelberg, L., Browner, C. H., Lejano, E., & Arangua, L. (2004). Access to women's health care: a qualitative study of barriers perceived by homeless women. Women & health, 40(2), 87-100. https://doi.org/10.1300/J013v40n02_06 DOI: https://doi.org/10.1300/J013v40n02_06

Gibson, B. E., & Mykitiuk, R. (2012). Health care access and support for disabled women in Canada: falling short of the UN Convention on the Rights of Persons with Disabilities: a qualitative study. Women's health Issues, 22(1), e111-e118. https://doi.org/10.1016/j.whi.2011.07.011 DOI: https://doi.org/10.1016/j.whi.2011.07.011

Hashemi, G., Wickenden, M., Bright, T., & Kuper, H. (2022). Barriers to accessing primary healthcare services for people with disabilities in low and middle-income countries, a Meta-synthesis of qualitative studies. Disability and rehabilitation, 44(8), 1207-1220. https://doi.org/10.1080/09638288.2020.1817984 DOI: https://doi.org/10.1080/09638288.2020.1817984

Horner-Johnson, W., Fujiura, G. T., & Goode, T. D. (2014). Promoting a new research agenda: Health disparities research at the intersection of disability, race, and ethnicity. Medical Care, 52, S1-S2. 10.1097/MLR.0000000000000220 DOI: https://doi.org/10.1097/MLR.0000000000000220

Kallianes, V., & Rubenfeld, P. (2014). Disabled Women and Reproductive Rights. In Reproduction and Society: Interdisciplinary Readings (pp. 219-232). Routledge.

Lebrasseur, A., Fortin-Bédard, N., Lettre, J., Bussières, E. L., Best, K., Boucher, N., ... & Routhier, F. (2021). Impact of COVID-19 on people with physical disabilities: a rapid review. Disability and health journal, 14(1), 101014. https://doi.org/10.1016/j.dhjo.2020.101014 DOI: https://doi.org/10.1016/j.dhjo.2020.101014

Lee, K., Devine, A., Marco, M. J., Zayas, J., Gill-Atkinson, L., & Vaughan, C. (2015). Sexual and reproductive health services for women with disability: a qualitative study with service providers in the Philippines. BMC women's health, 15, 1-11. https://doi.org/10.1186/s12905-015-0244-8 DOI: https://doi.org/10.1186/s12905-015-0244-8

Lord, J. E. (2007). Human Rights. YES! Action and advocacy on the rights of persons with disabilities. University of Minnesota Human Rights Center.

Mavuso, S. S. & Maharaj, P. (2015). Access to sexual and reproductive health services: experiences and perspectives of persons with disabilities in Durban, South Africa. Agenda, 29(2), 79-88. DOI: https://doi.org/10.1080/10130950.2015.1043713

McCarthy, M. (2009). Contraception and women with intellectual disabilities. Journal of Applied Research in Intellectual Disabilities, 22(4), 363-369. https://doi.org/10.1111/j.1468-3148.2008.00464.x DOI: https://doi.org/10.1111/j.1468-3148.2008.00464.x

Moodley, J., & Graham, L. (2015). The importance of intersectionality in disability and gender studies. Agenda, 29(2), 24-33. https://doi.org/10.1080/10130950.2015.1041802 DOI: https://doi.org/10.1080/10130950.2015.1041802

Moodley, J., & Ross, E. (2015). Inequities in health outcomes and access to health care in South Africa: a comparison between persons with and without disabilities. Disability & Society, 30(4), 630-644. https://doi.org/10.1080/09687599.2015.1034846 DOI: https://doi.org/10.1080/09687599.2015.1034846

Nguyen, A. (2020). Challenges for women with disabilities accessing reproductive health care around the world: a scoping review. Sexuality and Disability, 38(3), 371-388. https://doi.org/10.1007/s11195-020-09630-7 DOI: https://doi.org/10.1007/s11195-020-09630-7

Nosek, M. A., Howland, C., Rintala, D. H., Young, M. E., & Chanpong, G. F. (2001). National study of women with physical disabilities. Sexuality and disability, 19, 5-40. https://doi.org/10.1023/A:1010716820677 DOI: https://doi.org/10.1023/A:1010716820677

OMS (2021). Informe mundial sobre la violencia y la salud. OMS, Organización Mundial de la Salud.

Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., ... Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ, n71. https://doi.org/10.1136/bmj.n71 DOI: https://doi.org/10.1136/bmj.n71

Pérez-Curiel, P., Vicente, E., Moran, M. L., & Gómez, L. E. (2023). The right to sexuality, reproductive health, and found a family for people with intellectual disability: A systematic review. International Journal of Environmental Research and Public Health, 20(2), 1587. https://doi.org/10.3390/ijerph20021587 DOI: https://doi.org/10.3390/ijerph20021587

Read, S., Heslop, P., Turner, S., Mason-Angelow, V., Tilbury, N., Miles, C., & Hatton, C. (2018). Disabled people’s experiences of accessing reasonable adjustments in hospitals: a qualitative study. BMC Health Services Research, 18, 1-10. https://doi.org/10.1186/s12913-018-3757-7 DOI: https://doi.org/10.1186/s12913-018-3757-7

Rio‐Poncela, AM, & Rojas‐Pernia, S. (2024). Maternidad y discapacidad intelectual en España: dificultades vividas y deseos compartidos de cambio. British Journal of Learning Disabilities, 52 (2), 236-247. https://doi.org/10.1111/bld.12571 DOI: https://doi.org/10.1111/bld.12571

Sakellariou, D., Malfitano, A. P. S., & Rotarou, E. S. (2020). Disability inclusiveness of government responses to COVID-19 in South America: a framework analysis study. International journal for equity in health, 19, 1-10. https://doi.org/10.1186/s12939-020-01244-x DOI: https://doi.org/10.1186/s12939-020-01244-x

Servais, L. (2006). Sexual health care in persons with intellectual disabilities. Mental Retardation and Developmental Disabilities Research Reviews, 12(1), 48–56. https://doi.org/10.1002/mrdd.20093 DOI: https://doi.org/10.1002/mrdd.20093

Shakespeare, T. (2014). Disability rights and wrongs revisited. Routledge. DOI: https://doi.org/10.4324/9781315887456

Signore, C., Spong, C. Y., Krotoski, D., Shinowara, N. L., & Blackwell, S. C. (2011). Pregnancy in women with physical disabilities. Obstetrics & Gynecology, 117(4), 935-947. 10.1097/AOG.0b013e3182118d59 DOI: https://doi.org/10.1097/AOG.0b013e3182118d59

Sonalkar, S., Chavez, V., McClusky, J., Hunter, T. A., & Mollen, C. J. (2020). Gynecologic care for women with physical disabilities: a qualitative study of patients and providers. Women's Health Issues, 30(2), 136-141. https://doi.org/10.1016/j.whi.2019.10.002 DOI: https://doi.org/10.1016/j.whi.2019.10.002

Steele, L. (2008). Making sense of the Family Court's decisions on the non-therapeutic sterilisation of girls with intellectual disability. Australian Journal of Family Law, 22(1), 1-23.

Thomas, C. (1999). Female forms: Experiencing and understanding disability. Open University Press.

Tilley, E., Walmsley, J., Earle, S., y Atkinson, D. (2012). 'El silencio ruge': esterilización, derechos reproductivos y mujeres con discapacidad intelectual. Disability & Society, 27 (3), 413-426. https://doi.org/10.1080/09687599.2012.654991 DOI: https://doi.org/10.1080/09687599.2012.654991

UNFPA (2020). Impact of the COVID-19 Pandemic on Family Planning and Ending Gender-based Violence, Female Genital Mutilation and Child Marriage. United Nations Population Fund

United Nations. (2006). Convention on the Rights of Persons with Disabilities. Treaty Series, 2515, 3.

WHO. (2011). World report on disability. World Health Organization.

Yupanqui-Concha, A., Hichins-Arismendi, M., Mandiola-Godoy, D., Rodríguez-Garrido, P., & Rotarou, ES (2024). Acceso a servicios de salud sexual y reproductiva en Chile: mujeres con discapacidad y su experiencia con la violencia ginecológica y obstétrica. Investigación en sexualidad y política social, 1-14. https://doi.org/10.22355/exaequo.2022.46.0 6

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Publicado

28-03-2025

Cómo citar

Cánive-Gómez, A. M. (2025). La invisibilidad en el sistema sanitario - Barreras y desafíos en la atención ginecológica para mujeres con discapacidad. Acciones E Investigaciones Sociales, 46. https://doi.org/10.26754/ojs_ais/accionesinvestigsoc.20254611108
Recibido 2024-10-06
Aceptado 2025-01-29
Publicado 2025-03-28