Background: Accessibility and use of contraceptives among women with disabilities are very crucial to 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 of contraceptive use among married women with disabilities in Ethiopia are not well described. This study aimed to determine the factors of 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 02/2025 to March 17/2025. Cases were married women with disabilities using contraceptive methods, while controls were married women with disabilities not using contraceptive methods. The data were collected with face-to-face interviews using a structured questionnaire. A multivariable logistic regression analysis model was used to analyze the data. The adjusted odds ratio with a 95% confidence interval was used to report the measures of associations.

Results: This study revealed that being a follower of the Muslim religion (AOR=0.29; 95% CI: 0.10, 0.88). Higher educational attainment increased odds of use: primary level of 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 service accessibility (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 contraceptive services were associated factors of contraceptive use among married women with disabilities. Therefore, interventions shall focus on disability-inclusive education with engagement of religious leaders and on improving service accessibility through outreach or home-based services.

Zelalem Tenaw Bogale has completed his PhD in Public Health from Hawassa University, Ethiopia. He is an Associate Professor of Reproductive Health in the Department of Midwifery at Hawassa University, Ethiopia. He has over 15 years of experience in teaching, clinical practice, research, and capacity building in maternal, newborn, and reproductive health. His research interests include sexual and reproductive health, maternal and child health, family planning, and the reproductive health and rights of people with disabilities. He has authored more than 30 peer-reviewed publications in national and international journals and has presented his research at several national and international scientific conferences. He has been serving as a reviewer for several reputed international journals, including BMC and PLOS ONE, as well as the Ethiopian Journal of Medical and Health Sciences. In addition to his academic and research experience, he has extensive experience in training healthcare providers and collaborating with governmental and non-governmental organizations to strengthen reproductive health services in Ethiopia.