Factors associated with contraceptive use among married women with disabilities in Sidama National Regional State, Ethiopia: a case-control study

Abstract

Background: Accessibility and use of contraceptives among women with disabilities are crucial for preventing reproductive health problems, which results in a compounded burden of disability and additional reproductive health-related challenges, such as limited access to services, heightened vulnerability to reproductive health problems, and pervasive social stigma. However, factors associated with contraceptive use among married women with disabilities in Ethiopia are not well described. This study aimed to determine the factors associated with contraceptive use among married women with disabilities. Methods: A community-based case-control study design was conducted among 484 randomly selected married women with disabilities (323 controls/non-users and 161 cases/users) in the Central Sidama Zone from February 02 to March 17, 2025. The cases were married women with disabilities using contraceptive methods, while the controls were married women with disabilities not using contraceptive methods. Data were collected with face-to-face interviews using a structured questionnaire. A multivariable logistic regression analysis model was used to analyse the data. The adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used to report the measures of association. Results: This study revealed that being a follower of the Muslim religion was associated with a lower odds ratio (AOR = 0.29; 95% CI [0.10-0.88]). Higher educational attainment increased odds of contraceptive use: primary education (AOR = 3.40; 95% CI [2.03-5.71]) and secondary or higher education (AOR = 4.47; 95% CI [1.94-10.31]). Good knowledge about contraceptives (AOR = 4.27; 95% CI [2.24-8.13]), a positive attitude towards contraceptives (AOR = 3.61; 95% CI [2.14-6.09]), and accessibility of contraceptive services (AOR = 3.26; 95% CI [1.90-5.57]) were also significantly associated with contraceptive use. Conclusions: Religion, educational status, knowledge of contraceptives, attitude towards contraceptive use, and accessibility of services were associated factors associated with contraceptive use among married women with disabilities. Therefore, interventions should focus on disability-inclusive education, engaging religious leaders, and improving service accessibility through outreach or home-based services.