Background: Previous research has highlighted widespread public mis/perceptions that portray women with disabilities (WWDs) as asexual, less likely to marry, and often not interested in childbearing. However, evidence from high-income settings shows that many WWDs are sexually active and do have or want to have children. Notwithstanding this, very few studies have focused on understanding childbearing desires and motivations among WWDs in low-income settings. This qualitative research explored childbearing desires and motivations among WWDs in Ghana. Methods: A cross-sectional qualitative study was conducted with WWDs aged 18–49 years in Northern Ghana. The distribution of participants by disability types were as follows: physical disability/impairment (n = 37); visual impairment (n = 11); speech and hearing impairment (n = 14); epilepsy (n = ten); and albinism (n = five). A pre-tested open-ended thematic topic guide was designed and used to conduct in-depth interviews. Interviews were tape-recorded and later transcribed for analysis. Transcripts were coded using QSR NVivo 11 software. Thematic content analysis techniques were used to analyse and present the data. Results: Nearly all the WWDs interviewed were sexually active, desiring to have children, and intended to have as many children as they could support. Strong desire to experience the joy of motherhood; fear of social insecurity; fear of old age economic insecurity; desire to challenge stigma and negative stereotypes about disability, sexuality and motherhood; and desire for self-actualisation, were key motivations for childbearing. Conclusion: Our findings challenge existing negative public perceptions about the status of WWDs in relation to sexuality, childbearing and motherhood. More importantly, our findings suggest that if the Sustainable Development Goals related to universal access to sexual and reproductive healthcare are to be attained, WWDs must be targeted with quality sexual and reproductive healthcare information and services.
Keywords: Women with disabilities; Sexuality; Childbearing; Desire; Intension; Motivation; Motherhood; Ghana
Evidence from high-income settings shows that many women with disabilities do desire to get pregnant and give birth to their own children. In low-income countries however, there is poor understanding about what motivates the desire to have children among women with disabilities. This poor understanding could hamper provision of appropriate information, counselling and essential services to help women with disabilities properly plan and time their pregnancies. We conducted individual interviews with 77 women with different disabilities in Ghana to understand what their motivations for childbearing were. We found that many of these women wanted to have as many children as they could care for. Their motivations for wanting to have children were categorised into five. First, these women simply wanted to enjoy the experience of being a mother. Second, many of them wanted to have children because they were afraid of losing their marriage and/ or respect from family and community members. Third, many feared that if they did not have children, there will be no one to care for them (women) in old age. Fourth, others wanted to have children to show that having a disability did not mean that they could not have children and be mothers. Finally, many said they wanted to give birth because doing so made them feel empowered as valuable members of their families and communities. We recommend that women with disabilities should also be targeted with quality essential sexual and reproductive healthcare information, counselling and services to support them plan and time their pregnancies appropriately.
Disability may be defined as the consequence of an impairment that could be physical, cognitive, mental, sensory, emotional, developmental, or some combination of these that interacts with the natural or built environment to restrict an individual's ability to participate in what is considered normal in their everyday society [[
Considerable research has highlighted the fact that even though the United Nations' Convention on the Rights of Persons with Disabilities (UNCRPWDs) has brought improvements in many aspects of PWDs' lives [[
On matters of sexuality and reproductive health, research suggests that WWDs have largely been ignored [[
With specific reference to fertility desires and motivations for childbearing, evidence suggests that many WWDs desire and are able to have children [[
In low-income settings, a few area-based qualitative studies have also highlighted the fact that many WWDs are sexually active and do have or want to have children [[
In the social and behavioural sciences, many studies have explored such questions as what motivates people to bear children [[
In 'Childbearing motivations, desires, and intentions: a theoretical framework', Miller [[
A cross-sectional qualitative study was conducted. The design formed part of a larger multi-methods study that was conducted to examine the sexual, reproductive and maternal and child healthcare needs, behaviours and challenges of WWDs aged 18–49 years in Ghana between January 2018 and June 2019.
Empirical research was conducted in three districts (Central Gonja, Savelugu-Nanton, and Bunkpurugu-Yunyoo) in the Northern region of Ghana. We selected these districts because they had the highest disability rates in the region: Bunkprugu-Yunyoo (5.4%), Savelugu-Nanton (4.6%), and Central Gonja district (3.6%) [[
In terms of fertility and reproduction, the region is very pro-natalist, and had a total fertility rate of 6.6 children per woman as compared to the national average of 4.2 [[
Patriarchy and patrilineal descent ideologies shaped everyday social relationships in most communities in the region. Polygyny was a common form of marriage, affecting 42 and 27% of women and men respectively [[
Adult women aged between 18 and 49 years who had a disability either from birth or before they turned age 18 constituted the participants. We focused on disability before adulthood in order to better understand how this early experience of disability affected or would affect sexual health, reproductive and childbearing decisions. In total, 77 WWDs were included in the study. These were spread across five impairment/disability types: epilepsy (n = ten), physical disability/impairment (e.g. neuromuscular diseases, spina bifida, spinal cord injury, limbs amputation, muscular dystrophy, and polio-related injuries; n = 37), visual impairment (full blindness; n = 11), speech and hearing impairment (n = 14), and albinism (n = five).
A combination of purposive and snowball sampling techniques was used. The procedure for contacting and recruiting WWDs involved a number of steps. We contacted leadership of the Ghana Federation of Disability Organisations (GFD) at the regional capital (i.e. Tamale). The GFD is an umbrella civil society organization, comprising disability-specific groups in Ghana. We explained the purpose of our research and solicited support to recruit eligible participants. From this initial engagement, the research team was introduced to district-level leaders and representatives of various disability organisations in the three study districts. At the district levels, the GFD and local district assemblies had databases of PWDs. Following engagements with district-level leaders and representatives of various disability organisations, we were granted access to these databases. From these databases, we identified potentially suitable participants for inclusion in our study. The research team and Community-based Surveillance Volunteers (CBSVs) visited potentially eligible WWDs in their respective communities, where the purpose of the study and sampling procedures were explained.
Our initial engagement with potential participants allowed them to ask questions about the study, which the research team gladly answered. Each potential participant was given 1 week (from the date of this initial meeting) to decide whether to participate in the study. This was particularly important for those who were married, cohabiting or depended on their parents or other family members. Each participant was re-contacted by the volunteers after the one-week period. When the decision was in favour of participation, interview date, venue, time and language were agreed. We initially approached 75 eligible participants. Eight of them refused participation mainly due to husband's/partner's/guardian's disapproval. However, a number of those who refused participation suggested and directed us to a total of ten other potential participants, most of whom were not registered with either their local district assembly or the GFD in the district. Our final sample was 77 WWDs.
We collected data using in-depth interviews (IDIs). Many (n = 52) of the interviews were conducted in the local dialects: Gonja and Twi in Central Gonja district; Dagbaani in Savelugu-Nanton district; and Moar and Komba in Bunkpurugu-Yunyoo district. Four research assistants (two females with disabilities; one male with disability; and one male without disability) were trained to conduct the interviews in the local dialects. We also recruited and trained one female research assistant from the Ghana Association of the Deaf to conduct interviews using Sign Language with 14 participants who had speech/hearing impairments. All our research assistants were teachers with either Teacher Training College qualification or a university first degree. A few (n = 11) of the interviews were however conducted in English. Except five interviews, all participants gave permission for the interviews to be recorded with an audio-tape recorder. Hand-written field notes were also taken.
An open-ended thematic topic guide was designed and used to conduct IDIs. The guide covered several topics, including awareness and knowledge about sexual, reproductive and maternal health rights, access to healthcare services, and specific sexual, reproductive and maternal healthcare needs of women with different disabilities. Generally, the guide captured both positive and negative childbearing motivations. Positive motivations disposed WWDs toward having a child, while negative motivations disposed them toward avoiding childbearing [[
The guide was first developed in English. Our four research assistants translated it into the five local dialects. An independent language specialist (one per dialect) then checked the quality of the translation. All corrections were made before the guide was pretested. Following the pretest, further corrections were made before a final guide was agreed upon and used to collect data.
Thematic content analysis approach was used to analyse the data. This involved several steps. To begin, independent language translation specialists were engaged to transcribe all audio recorded interviews in the original interview language (i.e. Gonja, Twi, Dagbaani, Moar, Komba or English). All non-English transcripts were translated into English. The sign language expert also transcribed the sign language interviews into English. To ensure transcription quality, the first author and all the research assistants performed back-to-back translations on selected transcripts. All errors were corrected. All transcripts were edited to correct grammatical mistakes without altering original meanings. We read the edited transcripts severally to gain general understanding of the data. All transcripts were imported into QSR NVivo 11 software for data coding. The coding process involved critical review of each transcript, followed by coding into emerging themes. Finally, the themes were presented, and relevant quotes from the transcripts were used to support identified themes.
In order to ensure data quality and analytic rigour, a number of measures were implemented. Firstly, our research assistants were trained on several aspects of the research and data collection tools, including explaining the main objective of the study and the data collection technique. Secondly, the interview guide was pre-tested, which helped us to reframe unclear questions. Thirdly, the PI (first author) was actively involved in supervising the research assistants during the data collection process to ensure data quality. Finally, we regularly held meetings with research assistants to review the data collection process as well as reflect on how our individual biases could affect the data. This process of continuous reflexivity during the data collection process ensured that questions were appropriately asked and that our personal biases were minimised.
The youngest participant was aged 18 years and the oldest was 47 years. A little over half of the participants (
The first major theme that emerged relates to desire to have children. Except four participants, all expressed great desire to have their own children:"As you can see, I already have two children; I have always wanted to have children, so I am happy that I have them." (Speech Impaired, Savelugu-Nanton)."I have not given birth yet, but I certainly want to have children; why will I not want to have them, except that Allah does not will it?" (Visually impaired, Central Gonja).Even those participants who said they were infertile reported how unhappy they felt on a daily basis about not being able to have children."My parents gave birth to only female children, so when I was growing up I always wanted to have a brother but I did not have one ... so I said that I must give birth to a baby boy so that he can compensate for my loss. Well, I did not know that this disability will happen and I will not be able to have my own children. I really would love to have my own children, even if it is one ... and especially a boy, but now I cannot, and that pains me." (Physically impaired, Central Gonja).When adoption was raised as an option, only one out of the five participants who said they were infertile was supportive of the idea. Several reasons were given to explain why adoption may be practically impossible or socially undesirable:"Yes, I know adoption is an option, but do you think orphanages or anyone will easily give out children for adoption by a woman with my condition? I do not think so ... anytime I ask any of my friends or family members to let their children come and stay with me and help me, they often refuse ... you know there is stigma against people like myself." (Woman suffering epilepsy, Central Gonja)."Like you asked about adoption, that could be a solution; but you know in our community if you adopt, people will talk ... gossip that you cannot have your own child; that is why you have gone to adopt somebody's child. I am sure my husband will not even accept it; he might say, ok then, I will leave you [divorce me] and go and marry a woman who can have children. So, that is why I do not think this adoption thing will work." (Visually impaired, Savelugu-Nanton).In terms of the number of children they desired to have, many reported that they desired as many children as God/Allah would give them. This view was particularly pronounced among participants from rural settings:"Children are a gift from Allah, so I will have as many as Allah permits." (Speech impaired, Bunkpurugu-Yunyoo)."I already have one, and as you can see I am currently pregnant ... I will have as many children as God will give me ... why will I not have children if God gives them to me?" (Physically impaired, Central Gonja).Others said that their desired number of children would depend on whether they would be able to support those children, including sending them to school. This perspective was widely expressed among participants from urban settings."For me, the number of children I will have will depend on whether I can support them ... right now my husband and I are not living bad ... so maybe we can take care of three or four children ... but who knows, our situation could change tomorrow." (Woman suffering albinism, Bunkpurugu-Yunyoo).Among the four participants (three from urban settings and one from a rural area) who said they did not want to have children, two said they did not desire children because they did not think they will be able to take care of a child if they had one."Even if my husband will support me, I think it will be too difficult to take care of a child given my circumstances. So, I really do not want to complicate things with a child." (Physically impaired, Bunkpurugu-Yunyoo)."I do not have anything against people with disabilities who have children ... I just feel that in my situation I will not be able to take care of a child physically, emotionally and financially. Will people in this community not say I am irresponsible if I have a child that I cannot take care of? That is why I said I do not want a child." (Woman suffering eplipsy, Central Gonja).The other two did not want to have a child because they wanted to focus on their careers:"I know by God's grace if I want to marry and have a child I will be able to do it. I know I will also be able to take good care of the child; but I have chosen not to have a child because I want to focus on my career ... go back to school ... I want to study law and become a lawyer." (Physically impaired, Savelugu-Nanton).In sum, majority of our study participants, irrespective of disability type and place of residence, were very desirous of having their own children, the number of children desired being dependent on both nature (Allah/God), and economic capability.
To fully understand why many participants expressed great desire to have their own children, we explored the underlying motivational factors for childbearing. Five main thematic motivational factors emerged. These included the joy of motherhood, childbearing as a means of challenging stigma and negative stereotype, social security, economic security, and self-actualisation. In the next sections, we present our thematic analysis with supporting quotes to illustrate WWDs' motivations for childbearing.
Nearly all participants (
Many participants reported that they were motivated to get pregnant and bear their own children because of negative stereotypes people in their communities held about PWDs when it comes to sexuality and child bearing."For me getting married and getting pregnant and giving birth to my own children is a way of telling people and society that yes, I have a severe disability but I am not asexual ... I can have sex, get pregnant and give birth ... it is a way to say me too I can do it." (Physically impaired, Savelugu-Nanton)."The reason I want to have many children is because of society ... if you have a disability like me, people in this community think that you should only be concerned about your disability and not matters of sex, marriage or childbirth. Some even think that because of my disability, I cannot care for a child. So, because of all these negative things, I want to disprove all those who think I cannot do it" (Visually impaired, Central Gonja).One participant also narrated her experience like this:"When I was growing up and did not have a disability, I used to tell my mother and fellow girls about how I want to marry a very handsome man and give birth to beautiful children. But when my disability happened, everything started to change ... anytime I talked about marriage or childbearing, my mother will just say I should concentrate on my disability and stop disturbing her. As for the girls, they didn't even come around often, and when they did, they only talked about my disability ... anytime I want to talk of marriage or having children, they just laugh and ask me to concentrate on my disability. So, because of this, I said I was going to have a child, and now I have this strong boy here." (Physically impaired, Bunkpurugu-Yunyoo).When asked about how childbearing enabled them to challenge existing stigma and stereotypes, many participants indicated that their experience of disability gave them opportunities to even educate their children and potentially the larger society about difference.
Another factor that motivated childbearing among WWDs' is social security. Participants talked about social security in three distinct but inter-related ways. Many participants, especially those in marital relationships, talked about childbearing as a means to socially secure their position in marriage:"My motivation is that in our society, people expect us [referring to women], especially if you are married to have children. So, if you are married and you do not have children, then it is a big issue ... you may lose your marriage...but now that I have children, at least I know even if my husband leaves me [referring to divorce], it will be for something else. So, you can say that some of us give birth to secure our marriage and position in society." (Speech impaired, Bunkpurugu-Yunyoo).The issue of securing marital position was particularly pronounced among Muslims where polygyny was common."Are you asking why I gave birth ... I am married ... and I am expected to give birth. Everyone, especially my husband, expects me to give birth. I am sure if I did not, by now I will be out of my husband's house. The other thing is that, if I do not and my two other co-wives give birth, do you think my husband will remain married to me? I can tell you that if I did not have two sons for my husband, he would have chased me out of his house long ago. But now because of these children, he respects me despite the fact that I have this disability." (Woman suffering albinism, Savelugu-Nanton).Apart from securing marital unions, several participants also described how childbearing has brought them or could bring them social respectability, thereby protecting them from violence and abuse:"You are asking why I had children? Who will defend me if not my children? As a person with a disability, people used not to respect me ... I suffered abuse all the time. But when I had my children and as they grew older and were successful [one is a teacher, one is a nurse, and two are now in school], people started to respect me. Besides, people know that if they abuse me and my children hear about it, there will be trouble. So, I can say that I am doing well today and people in this community respect me because of my children, and that is why if I were younger, I would probably have more children." (Visually impaired, Central Gonja).In this way, childbearing acted as a social compensator for their disability, thereby increasing their acceptability and social respectability. Others also said that they were motivated to have children because it was the only way to ensure perpetuity of their own lineage and prevent generational loss."I am the only child of my parents; if I do not have children, then our lineage will just die out in the future. Besides, if I marry and do not have children, then my husband's lineage will also collapse. I do not want to be the one responsible for collapsing my parents' or husband's lineage ... that is bad omen, and that is why it is important for me to have children no matter how hard it is to care for them." (Physically imapired, Bunkpurugu-Yunyoo).
Participants' motivations for childbearing were also related to economic security, especially in the future."Now that my husband and I are still a little stronger, life is very hard ... no money and regular food. You can imagine what will happen in the future if there is no one to provide for us. So, my children, they are my future." (Physically impaired, Savelugu-Nanton)."For me, I want to give birth ... I want a boy ... somebody who will provide my needs when I am old." (Hearing Impaired, Central Gonja).Participants who were physically or visually impaired particularly talked about how by having children, they have been able to engage in productive economic activities, which contributed not just to improving their current economic situation, but also their future economic security via savings:"Before I started having children, I could not do much ... my movement was very restricted ...I could not go to the farm to harvest crops. But when I started having my children, they helped me ...they became my eyes ...they led me to the farm and even to the market. This has really helped me and I believe it will help me in the future. But for the fact that I had my own children, I do not know what would have happened to me especially after the death of my husband" (Visually impaired, Bunkpurugu-Yunyoo).Indeed, several accounts across different disability types and spatial contexts highlighted the economic vulnerability of WWDs, and how childbearing presented an opportunity to improve their future economic security.
Another motivation for childbearing among a substantial number of participants (
This study is one of the first in Ghana to focus on exploring childbearing desires and motivations among WWDs. Several aspects of our findings deserve further discussion and reflection. Following Miller's [[
Our finding that many WWDs valued the experience of being mothers provides important counterpoints to existing societal prejudices and misconceptions that often portray disabled women as incapable of desiring, having, caring for, and enjoying children [[
Our findings also revealed that many WWDs are motivated to have children in order to proof that they are both biologically and socially capable of being mothers. As noted throughout this paper, the mothering experiences of many WWDs are fraught with barriers, stigma, and surveillance. Our findings in this paper generally demonstrate that many WWDs are acutely aware of these prejudices and barriers, and are actively negotiating and challenging existing stereotypes by getting pregnant and bearing their own children. This agency clearly has theoretical and practical implications. First, it calls for critical engagement with disability in a way that questions how disability has come to be primarily conceptualized as a deficit or negative outcome in the first place [[
Several of our participants also reported fulfilment, empowerment and self-actualization as important motivations for childbearing. For many of the WWDs in our study, pregnancy and childbearing reaffirmed their feminine identity and sexuality as well as their self-worth as women. In previous studies, WWDs have commented on how becoming pregnant was experienced as an important achievement and affirmation of femininity, and how the experience of pregnancy confirmed that their biological bodies could function like those of women without disabilities [[
Fear of social and economic insecurities also emerged as important motivational factors for childbearing. Indeed, demographers and economists have historically found demand for labour and future economic insecurity as reasons underlying childbearing desires and intentions among men and women without disabilities [[
Finally, a few of our participants believed they were fertile but indicated that they did not want to have children. Reasons for the lack of desire for children ranged from practicable challenges of caring for children, voluntary infertility to fears that they may give birth to children with disabilities. We think it is very progressive that some WWDs are making childbearing decisions based on careful reflection on their social, economic and career situations. However, we are concerned that some of these decisions appear to be influenced by internalized stigma and fear of disability transmission. Not only did some WWDs wanted to avoid having a child with a disability but also, they seemed to endorse a belief that WWDs should not have children. We think reproductive health researchers and practitioners are well situated to provide support for WWDs who desire pregnancy and motherhood but may be facing uncertainty about risks and benefits of having a child with a disability.
Taken together, the conceptual framework we followed has enabled us to explore and reveal the formation of childbearing desires and underlying motivational factors among WWDs. These findings have implications for theory, reproductive health policy, and service delivery. First, our finding that WWDs are sexually active and are having children or desire to have children challenges existing mis/perceptions about the asexuality and motherhood incapability of WWDs. Second, these findings suggest a need to adequately attend to the sexual and reproductive healthcare needs and challenges of WWDs both in reproductive health policy-making and service delivery. In calling for a focus on the sexual and reproductive health needs of WWDs, we take cognizance of the fact that several of our research participants wanted to have as many children as God/Allah wills it. The rights of WWDs to marry and found a family and retain their fertility (Article 23), and have access to sexual and reproductive healthcare (Article 25), are all guaranteed under the UN Convention on the Rights of Persons with Disabilities [[
The findings reported in this paper should be interpreted with a number of limitations in mind. First, our sample comprised only 77 participants. While this sample size was adequate for a qualitative study like ours, we acknowledge the limitations of generalizing our results beyond our study context. This is particularly so given the pronatalist and patriarchal orientation of our research context. Secondly, while we implemented a number of research and data quality assurance measures, we acknowledge that some meaning may have been lost in the transcription and translation of non-English interviews. These limitations notwithstanding, we believe our findings offer important pointers to the need to adequately provide for, and address, the sexual and reproductive aspirations, needs and challenges of WWDs in policy and practice. Finally, disability often intersects with other vulnerabilities such as poverty and gender-based violence. While we endeavoured to include women with different disabilities in our study, our analysis did not explore in detail how the type of disability influences motivations for childbearing. Similarly, our study has not explored the intersections between disability and other vulnerabilities and how this intersectionality impacts on motivations for childbearing among women with different disabilities.
Contrary to popular perceptions about WWDs' asexuality or lack of desire for children, our study showed that many WWDs are sexually active, desired to have children, and intended to have as many children as they could support. These findings challenge existing negative public perceptions and stereotypes about the status of WWDs in relation to sexuality, childbearing and motherhood. More importantly, our findings suggest that if the Sustainable Development Goals (SDGs) related to universal access to sexual and reproductive healthcare are to be attained, WWDs must be targeted with quality sexual and reproductive healthcare information and services, including family planning information and services. If local governments and the global health community are truly interested in improving health for all, now is an appropriate time to question discourses around disability and its relationship to sexuality and motherhood. We should also actively identify and explore our own spheres of ignorance, and as well acknowledge that there are aspects of the experiences of WWDs that we know little or nothing about. We should also then be open to the possibility that these experiences may provide valuable lessons to propel progress towards achieving the SDGs related to universal sexual and reproductive healthcare. In this regard, we believe reproductive health practitioners are well situated to provide counselling and support for all WWDs who desire pregnancy and motherhood. Funding agencies and researchers also have critical roles to play in terms of directing research and deepening understanding of the reproductive health needs and challenges of WWDs, the context-specific strategies needed to develop and facilitate recognition of the sexuality and reproductive rights of WWDs, as well as how appropriate sexual and reproductive healthcare services could be made available and more accessible to WWDs.
This research was funded by an Early Career Research Fellowship grant from the Stellenbosch Institute for Advanced Study (STIAS), Wallenberg Research Centre at Stellenbosch University, South Africa.
We thank the Stellenbosch Institute for Advanced Study (STIAS) for funding this research. We are grateful to the leadership of the Ghana Federation of Disability Organisations in Tamale and in the three study districts for facilitating access to research participants. We are also grateful to our research assistants. Finally, we thank all the WWDs who participated in this study.
JKG conceived and designed the study. JKG, TR and JS performed literature search and review. JKG led the field work. JKG, TR, RRA contributed to data analysis and interpretation. JKG drafted the manuscript. TR, RRA and JS revised the first draft. All authors read and approved the manuscript for submission for publication.
All relevant data are included in this paper.
Ethical approval was obtained from the Ghana Health Service Ethics Review Committee (Protocol ID NO. GHS-ERC:007/07/17). Before each interview, informed consent was obtained. Research assistants first reviewed participants' information sheet and informed consent form with each participant. Through this process, participants were informed about the rational of the study, and study procedures. The benefits and risks of participation were also explained to each participant. Participants were then asked to sign or thumbprint the informed consent form to indicate their willingness to participate in the study. Each participant received a copy of the signed/thumb-printed consent form for future reference.
In addition, all interviews were conducted in venues that ensured maximum anonymity, confidentiality and privacy of all participants. Except a few visually impaired participants who were accompanied by personal assistants (usually a family member or CBSV), no third parties were present during interviews. While we initially obtained names and contact details of most participants from the GFD register, neither the names/addresses of participants nor any voice identifiers were used to identify individual participants in interview transcripts. Voice recorders, transcripts and field notes were entered into access-controlled and password protected computers, accessible only to the research team.
In terms of risks and benefits, no biological samples were collected, and participants were not exposed to any physical danger. However, the time participants spent responding to interviews could have come with other indirect opportunity costs. Also, a few participants (
All participants gave their consent for their responses to questions asked during the data collection for this research to be published anonymously. All authors have also consented to publication of this manuscript.
The authors declare that they have no conflict of interests.
• CBSVs
- Community-based Surveillance Volunteers
• GFD
- Ghana Federation of Disability Organisations
• IDIs
- In-depth Interviews
• PWDs
- Persons with Disabilities
• SDGs.
- Sustainable Development Goals
• TFR
- Total Fertility Rate
- UNCRPWDs
- United Nations' Convention on the Rights of Persons with Disabilities
• WWDs
- Women with disabilities
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By John Kuumuori Ganle; Rebecca Racheal Apolot; Tafadzwa Rugoho and Joshua Sumankuuro
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