The document explores women with physical disabilities' experiences accessing reproductive health care in Ho Chi Minh City, Vietnam, highlighting both positive experiences, such as improved infrastructure and knowledgeable health care providers, and negative barriers, such as inaccessible toilets and parking issues. While significant progress has been made due to government policies, disparities remain in the effectiveness of these initiatives across different localities. The conclusion suggests further improvements are needed to ensure equal access to reproductive health care for all women with disabilities.

1. monash.edu
ACCESS TO REPRODUCTIVE HEALTH CARE
OF WOMEN WITH PHYSICAL DISABILITIES IN
HO CHI MINH CITY, VIETNAM
Presenter: An Nguyen
09/11/2020

2. TABLE OF CONTENTS
1. Introduction
2. Research aim
3. Methodology
4. Research findings
5. Conclusion
6. Q&A

3. 1. Introduction
■Access to reproductive rights for WWDs is both a basic human
right and global public health goal.
– Article 5 – CRPD(UN): PWDs have the rights to access to
health without discrimination
– SDGs 3 (WHO) – healthy lives and promot[ing] well-being
for all at all ages

4. 1. Introduction (continued)
Reproductive health in Vietnam
• Vietnam is progressive in terms of reproductive health
• Most people can easily access contraception, and reproductive health is
openly discussed
• Several government policies actively promote reproductive rights
• Contraceptive use in Vietnam is high: ~80% of married women aged
15-49 use some form of contraception (GSO 2016)
• Yet these seem to ignore PWDs
• Decision 2013/QD-TTg identified the need for a reproductive health
care strategy addressing care needs of vulnerable groups
• Yet national standard guidelines on reproductive health care services
currently do not have standard guidelines for PWD, and PWD are not
specifically discussed in any reproductive policy initiatives

5. 1. Introduction (continued)
PWD in Vietnam
• At 2016, 6.19 mil PWDs documented in Vietnam
• 1 in 5 households have one or more PWD: mostly rural, living in
poverty, and impacted by disability and limited/no education
• The situation for PWD in Vietnam is not hopeful:
• High rates of unemployment: 1.69 times more likely than non-disabled
people
• Over the past decade, the Vietnamese Government has made
significant efforts to improve quality of life for PWD
• CRPD (2007/2015) seeks to recognize the rights of people with
disabilities
• Law on Disability (iss 2010, enact 2011): identifies rights of PWD
• No mention of rights related to reproductive health

6. 2. Research Aim
Research Aim
To explore women with physical disabilities’ experiences of
accessing reproductive health care in Ho chi Minh City, Vietnam

7. Selected site
3. Methodology

8. Data collection
■Ethnographic research was undertaken
– A scoping trip: Mar-Apr 2018: visiting some health services
– A field trip: Jun –July 2018: interviews
■In-depth interviews:
– 20 WWDs
– 5 Key informants
– 5 Health care providers
■Document analysis:
– Disability Law
– Health Insurance policy
– Family Planning policy, including family planning health report
– Policy for reproductive health
3. Methodology

9. 4. Research findings
Positive experiences
■Infrastructure improvements included the provision of ramps,
lifts, and wheelchairs at health services
Generally, it’s very accessible. They have ramps for wheelchair. They
have elevators at all almost buildings, so patients can get access to any
level (Thi, 34 years old, married, Bachelor, sale admin)
I saw they have available manual wheelchairs there. I can borrow it. If
I can not use by myself, a volunteer there is willing to help and push
me to the consultation room (Thanh, 37 years old, single mom,
Bachelor, office staff)

10. 4. Research findings (cont.)
Positive experiences (cont.)
Figure 1,2,3. Ramp, wheelchair, and lift at public health care services
1 2 3

11. 4. Research findings (cont.)
Positive experiences (cont.)
■Government health care cards for people with disabilities
entitled them to reduced fees or even free services, depending
on the assessment of their capabilities.
Figure 4. Government health insurance card
I got a government
health insurance
card. I did not pay
anything. It is 100%
free for me. (Thu,
53 years old, single
mom, 6/12, selling
lottery tickets )

12. 4. Research findings (cont.)
Positive experiences (cont.)
■Health care providers: more sensitive and knowledgeable about
people with disabilities.
– At Binh Thanh hospital, where I registered, they are vey nice
and friendly. Every time I go there, they always ask me if I
need a wheelchair, or a support. They also help me to register
at the counter and absolutely, I got a priority. And the doctor is
so knowledgeable. He advised me clearly about my case as a
pregnant woman with physical disability (Thi, 34 years old,
married, Bachelor, sale admin)
■=> These factors appeared to support people with disabilities to take
good care of their health.

13. 4. Research findings (cont.)
Negative experiences
■Some barriers when accessing health care services.
■Toilets were inaccessible for wheelchair users
– At Tu Du hospital, some toilets are inaccessible for
wheelchair users. One time, my husband had to carry me to
the toilet. Then he waited for me in the front of the toilet.
Once I had done, I called him comeback to take me out. Then
people there screamed at him “What? Why do you go here?
This is for female only”. Then he explained “my wife is here,
she can not walk” (Dinh, 38 years old, married, vocational
school, self-business at home)

14. 4. Research findings (cont.)
Negative experiences (cont.)
■Parking was far away the main entry or even not accept
the three-wheel motorbike
– The parking is a little bit far away the main entry. The entrance to
the parking is also too narrow for the three-wheel motorbike.
(Nhu, 40 years old, single, Bachelor, office staff)
– When I went to Cho Ray hospital, they denied my three-wheel
motorbike. They said my one occupied as much as two motorbikes
(Dinh, 38 years old, married, vocational school, self-business at
home)

15. 5. Conclusion
■Almost all women with physical disabilities had positive
experiences when accessing health care services. This likely
relates to the Vietnamese Government’s recently implemented
Disability Law, which has brought about a number of changes
related to health care, including allowances, reduced rates and
new infrastructure.
■However, not all people with disabilities are benefiting equally,
due to differences in the capacity of local governments to
operationalise the law.
■Women with physical disabilities’ access to reproductive health
care could be further improved by improving the capacity and
knowledgeability of local law officers.