Exploring the knowledge and experiences that people with spinal cord injury have when accessing sexual reproductive health services in Blantyre, Malawi

Abstract

Introduction Spinal cord injury is a debilitating condition with life changing impairments which results in sexual reproductive health problems (SRHP). Unfortunately, physical rehabilitation for spinal cord injury often overlooks SRHP resulting in people with spinal cord injury (PWSCI) being discharged without support. This study aimed at exploring knowledge and experiences of PWSCI when accessing sexual reproductive health services (SRHS) in Blantyre, Malawi. Methodology Fifteen face-to-face in-depth interviews were conducted with PWSCI discharged from Kachere Rehabilitation Centre. Data was analysed thematically using NVIVO. Findings Six themes emerged: (I) PWSCI have knowledge on SRHS which is sourced from health workers and friends with a similar condition, (ii) positive experiences involved good attitude of health workers, (iii) negative experiences were lack of privacy during treatment sessions, (iv) barriers to access of SRHS incorporated service delivery gaps in public facilities, (v) facilitators to accessing SRHS included adequate psychosocial support from spouse, family and community, (vi) improvements to SRHS and physical rehabilitation service can enhance access of SRHS. Conclusion Awareness of SRHS is available among PWSCI in Blantyre, however there is a lack of detailed SRHS discussions in physical rehabilitation. Knowledge sharing through sexual education and pamphlets of information can enhance awareness. Negative experiences are more common than positive experiences among PWSCI when accessing SRHS. Improvements to SRHS and physical rehabilitation services through: staff training, equipment availability, family psychosocial support and quality infrastructure can alleviate bad experiences and enhances access of SRHS.