Intimate partner violence, reproductive health outcomes, and responsiveness among women living with disabilities in Southern Ethiopia: a qualitative study.

Abstract

Background: Intimate partner violence (IPV) is a major public health concern that disproportionately affects women with disabilities. While studies have identified factors associated with IPV, there is limited documentation on its impact among women with disabilities in Ethiopia. This gap hinders the development of targeted interventions. This study aimed to explore the impact of IPV on women with disabilities, focusing on the intersection of gender, disability, and reproductive health outcomes, as well as the responsiveness of services in Southern Ethiopia.

Methods: A community-based ethnographic qualitative study was conducted from January to September 2024 in Southern Ethiopia. Participants were selected using purposive sampling with a snowball approach and included women aged 16 years and older. Data were collected through twelve in-depth interviews from women with disabilities who had experienced IPV, as well as five key informant interviews with professionals who had direct engagement with issues related to IPV and disability. Reflexive thematic analysis was conducted using Open Code software version 4.2.

Results: All participants reported experiencing multiple and intersecting forms of IPV, often occurring over extended periods and involving emotional, physical, sexual, and disability-targeted abuse. Six main themes emerged: (1) history of multiple forms of violence by intimate partners (2), triggers of IPV, including societal stigma, perceived helplessness, and the intersection of gender and disability (3), disability-targeted violence (4), maternal and reproductive health consequences, such as self-managed abortion, miscarriage, malnutrition, preterm birth, intrauterine growth restriction, and low birth weight (5), lack of legal responsiveness, including weak law enforcement and inadequate protection for victims, and (6) accessibility and responsiveness of maternal, reproductive health, and IPV-related services.

Conclusion: Women with disabilities in Southern Ethiopia face compounded risks of IPV, driven by stigma, gender inequality, and limited legal protection. IPV during pregnancy poses serious health risks for both mother and child. Inadequate access to sexual and reproductive health services further increases their vulnerability. Strengthening legal frameworks, improving service access, and training providers to recognize all forms of IPV are vital steps toward safeguarding their rights and well-being.