Accessing Sexual and Reproductive Health Services during climate change-related environmental disruptions in Coastal Ghana: A Privilege or Human Right for young women with disabilities?

Introduction: Climate change is increasingly recognised as a threat to global health, yet its influence on the sexual and reproductive health and rights (SRHR) of young women with disabilities (WwD) remains poorly documented in Ghana. Human rights advocates contend that categorising SRHR services for WwD as privileges diminishes essential entitlements and promotes inequality.

Methods: In this study, we examined the lived experiences of WwD in accessing SRHR services during climate change-related environmental disruptions in a coastal Ghanaian community to inform policy. A qualitative exploratory design was used. Semi-structured interviews were conducted between March and May 2025 with ten young WwD who accessed SRH services in the community. Interviews were conducted in English or a local language, audio-recorded, transcribed, and analysed using framework analysis. The analytic process was guided by the study objectives and informed by the behavioural assumptions of the Theory of Reasoned Action and the Theory of Planned Behaviour.

Results: Climate change-related flooding and erosion, along with inadequate sanitation facilities, negatively impact the SRHR of young WwD by restricting access to services, hindering mobility and communication, and increasing risks related to menstrual hygiene and infections. Women with disabilities faced unique challenges during flooding, including dependence on others, navigating unsafe areas, and limited access to SRH information. Their vulnerabilities were exacerbated by the intersections of gender, disability, poverty, and coastal geography. Participants used improvised coping strategies, revealing gaps in disability-inclusive climate change and health planning.

Discussion: Climate change exacerbates existing inequalities, putting young WwD at increased risk of exclusion from SRH information and services. Young WwD in coastal Ghana accessing SRHR services during climate change-related disruptions is a human rights issue. There is a pressing need to improve climate change adaptation for them, enhance infrastructure accessibility, and include them in community planning. Further research is suggested to guide national policy.