| Issue/Objective |
Access to perinatal care is a fundamental right, yet women with physical disability in Ethiopia face compounded barriers including lack of reproductive health information and negative societal attitudes rooted in misconceptions about motherhood. Research about disability and perinatal care in Ethiopia remains predominantly quantitative and urban-focused, lacking experiential insights from rural settings where many women with disability reside. In this study, we explored perinatal care access for women with physical disability in rural Ethiopia. |
| Methodology/Approach |
We conducted an instrumental qualitative case study in East Dembia Woreda (resembling a district), Ethiopia (April 2021-May 2023), guided by Levesque's health care access framework and intersectionality theory. Twenty-four participants were purposively recruited: 12 women with physical disability, 5 close persons, and 7 perinatal care providers. Data were collected through semi-structured interviews, facility observations, and a review of seven maternal health policy documents. Reflexive thematic analysis and triangulation were applied. |
| Results |
Two major themes and 4 sub-themes were developed. The two themes were "Navigating the physical environment" and "Exploring perinatal care services." In navigating the physical environment, disability, rural residence, and poverty intersected to create transportation barriers. Women often walked long distances despite pregnancy-related exhaustion, with some reporting falls. Inaccessible settings in health facilities hindered service use. In accessing perinatal care services, women encountered long queues without accommodation, limited informed consent, dismissive attitudes, and minimal postnatal care. Providers reported limited training and sometimes assumed cesarean delivery was an optimal delivery method due to women's disability rather than determining the delivery method through individual assessment. Policies emphasized on universal health care coverage but lacked disability-specific implementation guidance. |
| Discussion/Conclusion |
Perinatal care access for women with physical disability is shaped by intersecting barriers -disability, gender, rural residence, and poverty. Addressing these barriers that results in inequitable perinatal health care access requires multi-level interventions that includes, strengthening transportation, implementing inclusive infrastructure standards, provider training, and person-centered care practices. Intersectional solutions, strategies, and policies are essential for responsive perinatal services in Ethiopia. |
| Presenters and Affiliations |
Dawit Mekonen York University |
