Afghanistan, Nepal and Tajikistan

Although approximately 15% of the world’s people have disabilities, many people with disabilities are marginalized and their sexual rights are not recognized. The work of the Family Federation of Finland in Afghanistan, Nepal and Tajikistan raises awareness of the rights of people with disabilities and provides tools for claiming these rights. In Tajikistan, for example, groups of women with disabilities have, after training, called on local authorities to make health services accessible.  

Our partners play a crucial role in ensuring that persons with disabilities are well-informed about their sexual and reproductive health and rights, as well as their own boundaries and how to safeguard them.

Our work takes place at individual level and includes activities such as facilitating peer support groups and training persons with disabilities to become peer educators and sexual health counselors who can provide sexual health information and contraceptives within their communities. For instance, our partner organization in Tajikistan, Ishtirok, organizes summer camps for persons with disabilities to learn about topics like sexuality, relationships, bodily autonomy, contraception, personal rights and recognizing sexual violence. As a result, this approach enhances their independence, self-esteem, self-confidence and their ability to advocate for their rights.

We work in collaboration with civil society, involving partnerships with other NGOs, including those focused on disability rights and sexual health. The goal is to foster a broader understanding within civil society and garner support for the promotion of sexual rights for persons with disabilities. In Afghanistan, for instance, our partner, a specialist in sexual and reproductive health, has provided sexual health training to disability organizations. Additionally, members of civil society in Afghanistan, such as university teachers, parents, religious leaders and community leaders, have also received training on sexual and reproductive health.

Furthermore, this approach involves shaping the structures and services within society with the goal of enhancing the accessibility of local sexual health centers and improving the knowledge of staff regarding disability-friendly services. It also seeks to influence policy and bolster the understanding of public authorities regarding their responsibility to provide accessible services.

For example, our partner in Nepal, the Family Planning Association of Nepal, has been engaged in advocacy efforts for years, aiming to establish national guidelines for disability-friendly maternal and reproductive health services. In December 2022, the Ministry of Health in Nepal issued the guidelines that specify regarding the provision of services that they need to be accessible, confidential, private and free (for specific groups). These guidelines also mandate the allocation of local budgets to promote these services.

Afghanistan 

Afghanistan is one of the poorest and most fragile states in the world. Violence has dominated the country for decades and the situation remains difficult. Afghanistan is also considered the most dangerous country in the world for women.
From the sexual rights perspective, the biggest challenges are high maternal mortality, cultural barriers to accessing sexual health services, and poor health services. Women’s independent movement to health services is restricted, and on the other hand, cultural reasons may prevent women from attending a male doctor’s office.

There are millions of people with disabilities living in Afghanistan and violence continues to cripple them. Health services are poor and difficult for everyone to access, but girls and women with disabilities in particular are easily excluded from all services. In addition, it is difficult for people with disabilities to get to school: an estimated 72% of people with disabilities have missed out on any form of education.

Nepal 

Nepal is located in Asia between China and India, and is one of the poorest countries in the world.
From the sexual rights perspective, the biggest challenges in Nepal are child marriages and maternal mortality. Maternal mortality has been reduced, but it remains one of the leading causes of death for women of childbearing age in Nepal.

In Nepal, young people make up a large proportion of the population, and approximately one third of Nepal’s population is young. Child marriages and early pregnancies are common, and teen pregnancies in particular are more common in rural areas than in cities.

In Nepal, almost half of young people aged 15-19 would like to use contraception, but they do not have access to it. More than half of married women did not use any form of contraception. In addition, more than one in five women aged 15-49 in Nepal has experienced sexual violence. The perpetrator of sexual violence is most often the husband.

In 2017, a practice called chhaupadi was banned in Nepal, where a woman was forced to leave her home during her period and was not allowed to come to the kitchen, touch food, religious objects, cattle or men. Menstruation was seen as dirty as well as unclean, and as a result, women ended up in solitary confinement during their menstruation. Although the tradition is an act prohibited and punishable by law, it is still practised in rural areas.

The sexuality of people with disabilities is a taboo in Nepal. It is challenging for people with disabilities to have access to sexual health services, for example, because health care facilities are not accessible. Personnel may also have preconceived notions about the sexuality of people with disabilities, in which case they do not feel they need the services. People with disabilities also have no knowledge of the services to which they are entitled.

Tajikistan 

Tajikistan is one of the poorest countries in Central Asia. The population is also very young, with almost 60 per cent under the age of 24. From the sexual rights perspective, the biggest challenges in Tajikistan are, in particular, the poor knowledge of young people about sexual health and sexual rights, which is reflected, for example, in the low use of contraception. 

The situation of the rights of people with disabilities is weak, as the majority do not have access to education or paid employment. Violence against women with disabilities and its various forms are common, and most women do not have the knowledge or resources to report acts of violence to the authorities. 

As in most countries, in Tajikistan the sexuality of people with disabilities is a taboo. Access to sexual health services can be very difficult due to either physical barriers or negative attitudes of the personnel. People with disabilities often have no knowledge of the services to which they are entitled.