Barriers to access reproductive and sexual health services among women with disabilities in Australia: a systematic review.

BACKGROUND

Women with disabilities in Australia experience persistent inequities in accessing sexual and reproductive health (SRH) services. Despite accounting for 21.8% of Australian women, structural barriers in policy, clinical practice, and service delivery continue to limit equitable access. This systematic review synthesises current evidence on the structural barriers shaping SRH service use among Australian women with disabilities, highlighting unmet needs and gaps to inform policy and guide future interventions.

METHODS

A systematic search of PubMed, Europe PMC, Google Scholar, and grey literature (2010-2025) was conducted following PRISMA reporting guidelines. Eligible studies examined barriers to SRH service access among women with disabilities in Australia. Screening, data extraction, and quality appraisal were performed using standardised tools (AMSTAR-2, NOS, CASP). Findings were synthesised thematically and mapped onto Levesque's conceptual framework for patient-centred access to health care to interpret various dimensions of SRH access.

RESULTS

Six studies met the inclusion criteria, encompassing reviews, surveys, qualitative research, and policy analyses. Across studies, barriers to SRH access for women with disabilities emerged consistently at systemic, provider, individual, and intersectional levels. Key issues included policy gaps, fragmented NDIS-healthcare pathways, limited provider training, inaccessible communication, stigma, and pronounced rural inequities. Mapping findings to Levesque's framework showed constraints across all supply- and demand-side dimensions, highlighting widespread barriers to equitable SRH access.

CONCLUSIONS

This review demonstrates that Australian women with disabilities face persistent, multi-level barriers to SRH access, shaped by policy gaps, provider limitations, and structural inequities. Strengthening disability-inclusive policy design, improving provider competency, and enhancing decision-making support are essential to promote equitable, accessible, and rights-based SRH services.