Barriers and facilitators impacting access to sexual and reproductive health services for women with intellectual disability.

Background: In most parts of the world, people with disabilities are deprived of education, employment, health, and social and political rights. Moreover, women with disabilities can be subjected to double discrimination because of their gender and are more likely to experience physical, mental, and sexual abuse. Because of the nature of their disability, women with intellectual disability in particular face stigma and discrimination in accessing sexual and reproductive healthcare, which in turn affects their decision-making abilities regarding sexuality. In Ethiopia, due to a lack of resources and limited awareness, women with intellectual disabilities have difficulties accessing sexual and reproductive healthcare to meet their needs. We, therefore, aimed to explore the barriers and facilitators impacting access to sexual and reproductive health services in Gondar, Ethiopia. Methods: The study employed a qualitative descriptive approach to explore the existing barriers and facilitators impacting access to sexual and reproductive health services, aiming to inform how to improve service provision for women with intellectual disabilities in Gondar, Ethiopia. Using a semi-structured interview guide, we conducted interviews in Amharic with 17 purposively selected women with intellectual disability, aged 15-49, in Gondar, Ethiopia. After the interviews were transcribed, we conducted a thematic analysis using both inductive and deductive approaches in NVivo 14. Results: The analysis of the study resulted in six themes reflecting on different barriers and facilitators impacting Sexual and reproductive healthcare access: sexual and reproductive health education, contraception, prevention of sexual abuse, prevention of sexually transmitted infections, pregnancy and parenthood, and the roles of community-based rehabilitation impacting access to Sexual and reproductive health services. Conclusions: Study findings showed the barriers and facilitators impacting access to sexual and reproductive health services for women with intellectual disability, based on firsthand information and experiences of these women embedded in structural and sociocultural factors. The study's findings could guide future researchers, healthcare policymakers and healthcare practitioners to design culturally appropriate and disability inclusive interventions promoting sexual and reproductive healthcare access and improved outcomes among women and girls with intellectual disability.