Socio-demographic characteristics of study participants
The study included 12 victims of IPV and five key informants from the disability association, health facilities, and the women and children affairs department. The ages of the IPV victims ranged from 25 to 37. The educational status of the IPV victims varied, with the lowest level being Grade 8 and the highest being a Master’s degree. Nature of employment status ranged from students to housemaids, self-employed individuals, and government employees. At the time of the interview, eight IPV victims were separated from their husbands, four were in relationships. The educational levels of the IPV victims’ spouses ranged from no formal education to a Master’s degree, with employment statuses ranging from private business owners to teachers and accountant. Regarding alcohol use, husbands or partners of IPV victims exhibited varying behaviors, from never drinking to frequently getting drunk. The onset of disability for most victims occurred in childhood, with seven victims experiencing physical disabilities and five being blind. Three victims had no children, while the others had between one and three children. A majority of participants reported a lower economic status, with a few identifying as having a medium economic status (Table 1).
In this study, 153 codes, 15 categories, and six themes emerged from the data analysis. The analysis identified the following main themes: history of multiple violence by a partner(s), triggers of IPV attacks, maternal and reproductive health consequences, lack of legal responsiveness, women with impairments feelings about the availability of maternal and reproductive health facilities, and the availability of IPV-related services (Table 2).
Theme 1 history of multiple IPV from a partner(s)
WWD endure various forms of IPV, including emotional, financial, physical, and sexual abuse. Emotional violence was universal, with partners demeaning them, using derogatory names, and treating them as disposable. Many partners exploited women with impairments for sex, financial gain, or property before abandoning them. They often manipulated women with impairments into trust and affection, only to withdraw when they no longer found the relationship beneficial.
Physical violence ranged from threats at knifepoint to severe beatings. Sexual violence involved rape, forced intercourse, and coercion into painful acts. A 28-year-old mother of three recalled, “He forced me into sex, regardless of my well-being. If I couldn’t comply due to my disability, he would beat and insult me, calling me ‘leper’ and ‘useless” (IDI/001/2024). Similarly, a 25-year-old woman faced coercion and threats. “He would come whenever he wanted sex, forcing himself on me, and calling me a ‘leper with nothing to offer’ when I refused to give him money.” (IDI/011/2024).
Infidelity was another common issue, reinforcing feelings of worthlessness. Many women remained in abusive relationships due to fear of societal judgment. A 28-year-old woman stated, “After learning of his affair, I refused sex. He beat me, held a knife to me, and raped me repeatedly. I stayed because I feared the stigma of divorce.” (IDI/004/2024). The emotional toll of betrayal left many WWDs feeling trapped, isolated, and struggling to navigate an already challenging reality.
Women who became disabled after marriage often faced rejection. A 25-year-old, who suffered a stroke after childbirth, recalled, “I asked him to buy me clothes, and he threw me 50 birr, saying I was no longer beautiful.” Others were abandoned entirely. A 30-year-old woman stated, “His family evicted me, took all my money, and said my blindness was punishment for my sins.” (IDI/011/2024). These experiences illustrate how pervasive societal stigma surrounding disability contributes to the risk and perpetuation of IPV.
Financial abuse was also widespread. Some partners targeted women with impairments for material gain, pretending to love them while exploiting their disability benefits, property, or savings. A 33-year-old explained, “He assured me of his continued support, but ultimately broke that promise. When I lent him the money I had been saving for a house, he disappeared.” Another woman revealed, “My husband married me just to claim half my house. When we divorced, he admitted it had all been a scheme.” (IDI/004/2024). Economic abuse further exacerbated their vulnerability, leaving many without financial security or the means to escape their circumstances.
While the accounts of IPV highlight the types and severity of abuse endured by women with disabilities, understanding the broader context is essential. The next theme explores the underlying societal and relational triggers that perpetuate and justify such violence.
Theme 2 triggers of violence
Category 1 bad societal perception towards disability
Women with impairments explained that partners were often influenced by societal negativity toward disability. A 25-year-old mother stated, “Whenever he visited his family, he returned home angry and regretful. He would say, ‘My family mocked me and asked me to divorce you because you are a crippled woman who didn’t deserve to marry a man like me.” (IDI/002/2024).
Negative perceptions also led women to tolerate abuse. A 37-year-old blind woman shared, “Growing up, I wasn’t welcomed by society. Even my parents concealed my condition, perceiving it as a misfortune or social burden. This gave me low self-esteem. When my partners mistreated me, I stayed silent, believing God was favoring them.” (IDI/003/2024). Deep-rooted societal bias made WWDs believe they were underserving better treatment, reinforcing cycles of abuse.
Category 2 double burden of gender and disability-based discrimination
In patriarchal communities, women are often regarded as dependent and inferior. For women with disabilities, this discrimination is compounded by ableism, resulting in a double burden that exacerbates their vulnerability to IPV. Participants described how societal norms permitted—and in some cases even justified—abuse against them.
A 25-year-old woman shared: “My ex-husband didn’t want me to socialize. One day, he caught me chatting with a neighbor, got angry, and threw a flamed object at me. When I screamed, neighbors scolded me instead, saying, ‘Why don’t you obey him? He just loves you.” (IDI/009/2024). This account highlights not only the abuse but also the disturbing community reinforcement of her suffering. Rather than protecting her, neighbors normalized the violence by framing it as an expression of care, thereby silencing her resistance.
Another participant, a 32-year-old woman with a visual impairment, recounted: “He often reminded me that I was lucky he married me because no one else would. When I tried to complain to his family, they said, ‘At least he didn’t abandon you. Who else would feed you?.” (IDI/001/2024). This example illustrates how social stigma and low expectations for WWD further discourage help-seeking and promote tolerance of abuse. The dependency narrative imposed by both partners and society restricts autonomy and perpetuates cycles of violence.
A third respondent noted: “I am disabled, but I am also a woman. These two labels make life harder. You are not listened to, not respected, and when something happens to you, everyone acts like it’s your fault.” (IDI/009/2024). Together, these testimonies demonstrate that WWDs not only experience IPV but also face systemic neglect and discrimination that make it difficult to escape abusive situations. The intersection of gender-based and disability-based discrimination intensifies their isolation and strips them of the social capital necessary to resist or report abuse.
Category 3 being helpless and defenseless (power inequality)
Women with impairments often depend on partners for survival, making them vulnerable to abuse. A 28-year-old physically disabled woman shared, “I have no one to confide in. My husband knew this, so he beat, insulted, and sexually assaulted me. I couldn’t even defend myself. When I cried, he said, ‘You have nowhere to go and no one will believe you.” (IDI/001/2024).
Category 4 disability-targeted abuse
Some partners used a woman’s disability as a reason to inflict abuse. A 28-year-old woman stated, “When he saw me limping, he would say, ‘I’ll break your other leg and leave you on the street.’” Another woman shared, “During sex, he ordered me to kneel. When he saw my disabled part, he became irritated and forced himself on me, cursing my limitation.” (IDI/002/2024). Such violence specifically targeting their disability further diminished their self-worth and sense of security.
Theme 3 maternal and reproductive health consequences
Category 1 negative child health outcomes
IPV during pregnancy led to severe fetal health complications. Many women reported intrauterine growth restriction (IUGR), poor nutrition, and high stress as major contributors. A 28-year-old woman explained, “He banned me from getting food. I was diagnosed with intrauterine growth restriction and gave birth to a preterm baby who was low birth weight.” Another woman added, “I had severe malnutrition and was diagnosed with IUGR.” (IDI/002/2024).
Low birth weight and preterm birth were common outcomes. A 25-year-old blind woman recalled, “I didn’t get enough sleep or eat enough. I was worried, which caused me to give birth to a low birth weight child who spent almost three months in an incubator.” (IDI/008/2024). The consequences of IPV during pregnancy had long-term health effects on children, perpetuating intergenerational disadvantages.
Category 2 negative maternal and reproductive health outcomes
Unwanted pregnancies were significant issues for women with impairments, especially those who were sexually abused. A 29-year-old blind woman shared, “He raped me and got me pregnant immediately. The pregnancy was totally unwanted, and I refrained from ANC follow-up as I felt ashamed.” (IDI/011/2024). Another woman reported, “My partner’s coercion resulted in an unwanted pregnancy that changed my life completely.” (IDI/012/2024). Unwanted pregnancies were significant issues for women with disabilities, especially those who were sexually abused. One woman, who was blind, shared that her pregnancy resulted from rape, and she refrained from antenatal care visits due to feelings of shame. This unwanted pregnancy negatively impacted on her life.
Women also faced maternal complications, including miscarriages and high-risk pregnancies due to stress and physical abuse. A 30-year-old woman stated, “I lost my baby because of the stress and beatings. I was hospitalized, but he never visited.” (IDI/011/2024).
WWDs endure severe and multifaceted IPV, with emotional, physical, sexual, and financial abuse deeply intertwined. Many remain trapped due to fear, societal stigma, and a desire for love and belonging. The health consequences for both mothers and children are devastating, highlighting the urgent need for intervention, legal protection, and support services tailored specifically to WWDs. Addressing the root causes of IPV and societal attitudes toward disability is crucial in breaking the cycle of abuse and fostering a more inclusive and protective environment for WWDs.
Theme 4 legal responsiveness
Category 1 lack of law enforcement
The study emphasizes the inadequate legal protection for WWDs, particularly in cases of violence. Participants reported that gender-based laws did not sufficiently protect them, and perpetrators often received minimal punishment. A 28-year-old woman with physical disabilities shared her experience: “My husband had been beating me, burned me with flame, sexually abused me, but they only threw him in jail for only one week. It is difficult to provide evidence, especially for financial and emotional abuse” (IDI/009/2024). Another participant revealed: “When I sued him, I presented the receipt for the bank transfer and personal witnesses. The court didn’t take me seriously, as they perceived me as angry and wanting revenge. (IDI/07/2024). A 28-year-old woman also described how her divorce was mishandled: “When I filed for divorce, my ex-husband appealed to share the house I received from the disability association. The court shared it equally because I am disabled and have nowhere else to go.” (IDI/010/2024).
Many WWDs face difficulties in reporting emotional violence. A 28-year-old woman stated: “My husband always called me a crippled woman and made me feel bad. I never reported it because I couldn’t present evidence and knew how I’d be neglected in court.” (IDI/001/2024). Legal authorities often dismissed the cases of WWDs. One woman recalled: “They advised me to keep my relationship going and start a family instead of suing my husband for abuse. They said he’d help me with my disability”. (IDI/009/2024). Another 28-year-old shared: “When my husband beat me, burned me, and slapped me, the police just scolded him, saying it’s normal in marriages. They wouldn’t have said that if I were able-bodied.” (IDI/002/2024).
Category 2 lack of protection
Fear of retaliation from abusive partners kept many women from reporting violence. A 28-year-old woman revealed: “I filed a lawsuit after he threatened to break my leg and burned me. He was imprisoned for eight days, then smashed a window to break into my house and attack me again.” (IDI/009/2024). Another participant expressed fear: “I never reported him to the police or anyone because I knew he’d attack me even more brutally” (IDI/002/2024). Many women felt that legal authorities failed to provide protection, and their abusive partners would be more dangerous if they sought justice.
Category 3 fear of neglect
WWDs feared societal neglect, with some feeling that reporting abuse would damage their reputation. A 28-year-old woman explained: “I was raised to understand that my mother stayed silent about my father’s abuse. I never reported it because I didn’t want to harm my reputation in the community”. (IDI/002/2024). Women also reported that legal authorities tended to ignore their cases, viewing them as attention-seeking. One participant noted: “Police and others tend to ignore violence against WWDs because they view us as aggressive or overly dramatic.” (IDI/006/2024).
WWDs face significant legal challenges in reporting and seeking justice for abuse. The lack of enforcement of gender-based violence laws, insufficient protection from further harm, and the fear of social neglect prevent many women from accessing the legal support they need. Strengthening legal protections and ensuring the effective enforcement of laws would be crucial in supporting WWDs who experience violence.
Theme 5 WWDs’ feelings about availability of health services
Category 1 experience of discrimination
Many WWD described facing discrimination in health facilities, particularly regarding their sexual and reproductive health rights. Some were denied services or faced judgmental attitudes due to assumptions about their sexuality. A 25-year-old blind woman shared, “The health professional was shocked and mocked me, asking, ‘Does your blind self also have sex?’ After that, I stopped going to public facilities.” (IDI/007/2024). Another respondent from a disability association recalled, “A blind woman was made to stay near the toilet after giving birth. She got sick and was ignored by the administration—only legal action brought justice.” (KII/003/2024).
Despite these negative experiences, a few women described positive support. A 25-year-old with a physical disability said, “At the private clinic, they helped me emotionally and financially and even helped me escape an abusive relationship.” (IDI/004/2024). Likewise, another woman said, “The public health staff were encouraging—the real issue was transportation and infrastructure.” (KII/002/2024). Lack of disability-inclusive training among healthcare workers was a common concern. While the Ethiopian Center for Disability Development (ECDD) provides inclusion training, its reach is limited to only a few facilities.
Category 2 inaccessibility of health services
Most participants reported that health facilities—both public and private—were not designed with accessibility in mind. This included the absence of ramps, wheelchairs, and proper communication aids. A 28-year-old woman shared, “At the hospital, I had to go up five floors by myself. There was no ramp or wheelchair—it was very hard.” (KII/004/2024). Another woman said, “The OPD, lab, and wards are far apart. We’re forced to move between them in discomfort.” (KII/002/2024). These findings show that beyond discriminatory attitudes, the lack of accessible infrastructure further hinders WWDs from receiving adequate and dignified care.
WWD face significant barriers to accessing healthcare, including both discrimination and inadequate infrastructure. Discriminatory attitudes by healthcare professionals often lead to denial of services, while the lack of accessible infrastructure, such as ramps and wheelchairs, further complicates their ability to seek care. Improving healthcare training to be more disability-inclusive and making physical facilities more accessible are crucial steps in addressing these challenges.
Theme 6 limited availability of disability-friendly services
The study identified a significant gap in services aimed at addressing IPV for WWDs. While some women’s organizations existed, they lacked effective IPV prevention measures. A representative from the Disability Association shared: “There was only one project for disability-inclusive healthcare, but it didn’t improve access to maternal and reproductive health for WWDs.” (KII/004/2024). A 28-year-old woman voiced frustration with the legal system: “The women’s affairs office in government is just symbolic. They allow us to draft an application letter and submit it to court but don’t help us heal our issues. (IDI/002/2024). Heads of disability associations also criticized the legal system: “There’s partial enforcement of the law. The defense attorneys don’t take cases seriously, offering weak arguments.” (KII/005/2024).
There is a significant gap in services addressing IPV for women with disabilities. Women’s organizations and the legal system offer limited support, with ineffective IPV prevention measures and weak enforcement of laws. Women report frustration with the lack of practical assistance in addressing their issues.