In Iran, the prevalence of disability among women is approximately 10 per 1,000. Women with physical disabilities, particularly those living in underserved provinces, face significant multi-level barriers—individual, social, and structural—in accessing prenatal care. Drawing on international evidence and qualitative findings, these barriers may increase the risk of pregnancy-related complications and adverse maternal outcomes, while undermining health equity. The aim of this policy brief is to provide practical and actionable recommendations for policymakers to improve equitable access to prenatal care services for this population.
This policy brief is based on a qualitative study conducted through semi-structured interviews with 24 participants (12 women with physical disabilities and 12 healthcare providers) in Kermanshah Province. Key barriers were identified at two levels: stakeholders (negative attitudes, insufficient knowledge, and inadequate family support) and organizational/systemic factors (poor physical accessibility, inadequate insurance coverage, and the absence of specialized protocols). While the primary evidence is drawn from Kermanshah Province, the policy recommendations are formulated at the level of Iran’s national health system.
Proposed strategies include empowering stakeholders through mandatory training for healthcare providers and public awareness campaigns; establishing a structured support system (expanded insurance coverage, facility adaptation, and specialized transportation); reforming care processes and protocols (home visits and reduction of unnecessary referrals); and strengthening intra- and inter-sectoral collaboration (Ministry of Health, State Welfare Organization, and insurance bodies).
Phased implementation of these policies, led by the Ministry of Health and Medical Education with the participation of the State Welfare Organization and insurance organizations, can reduce adverse maternal outcomes, promote health equity, and prevent long-term costs. Failure to act will result in increased inequality, a greater financial burden on the health system, and violation of the reproductive rights of these women.