Sexual and Reproductive Health Service Utilization among Young Disabled People in Ethiopia: a cross-sectional study

Background: In Ethiopia, the delivery of sexual and reproductive health services (SRHSs) to young people with disability (YPWD) is poorly understood, as such they are often marginalized and not recognized as being sexual. This study, therefore, aimed to assess the sexual and reproductive health service utilization and associated factors among young people with disability in Ethiopia.

Methods: In 2012, a cross-sectional survey was conducted in Addis Ababa, Ethiopia; 426 young people with disability aged 10-24 years were systematically selected and included in the study. Data were collected by trained interviewers using a standardized questionnaire and analyzed using Predictive Analytics Software (PASW), version 20. All analyses used an alpha level of 0.05 (two-tailed) to determine statistical significance.

 Results: Only one-fourth of the young people with disability (26.1%) had ever utilized sexual and reproductive health services. The most commonly cited reasons for seeking sexual and reproductive health services were to get contraceptives (48.1%), to get condoms (21.2%), and for HIV counseling and testing  (21.2%). Sixty-three percent of the sexually active young people with disability had ever used a modern contraceptive method, and 54.3% had ever used a condom. Fifty-six percent of the participants had ever been tested for HIV. Being older, female, and literate were found to be important putative determinants of sexual and reproductive health service use according to logistic regression analysis. The main reasons for not utilizing sexual and reproductive health services were the inconvenience of health institutions (48.8%) followed by poor handling and scolding by the service provider (22.1%). 

Conclusions: This study revealed that many young people with disability in Ethiopia experience barriers to access sexual and reproductive health services, particularly due to inconvenient health institutions and poor handling by service providers. Not surprisingly, education plays an important role in sexual and reproductive health service use. However, the higher likelihood of using sexual and reproductive health services by older females, as in our study, could be evidence of a societal misconception that SRHSs are only for adults and women. It could also be an indication of the increased risk of females for sexual and reproductive health problems and the increased vulnerability associated with a lack of access to sexual and reproductive health services for younger people with disability. Therefore, an effort has to be made by program and policymakers, and other concerned parties to raise disability-related awareness at the societal level to foster respect for the rights and dignity of persons with disabilities. There is also a need to intervene on the available and upcoming sexual and reproductive health services and programs to make them youth and disability friendly.