Prevalence and Factors Associated with Violence; Perceived Social Support and Health Access Among People with Disabilities in Rural Districts of Southern Ethiopia: Mixed Study

Figures & data

Table 1 Study Variables and Their Operational Definitions

Variable	Definition
Sexual violence	If PWDs claimed that they experienced any one or more of the following: (1) being physically forced to have sexual intercourse against their will; (2) having sex while they did not want it because they were afraid of what the person might do, and (3) being forced to do something sexual that they found humiliating or degrading they were assigned as experienced sexual violence.
Physical violence	It was considered physical violence if any one or more of the following were experienced in the past year: (1) slapped or thrown something at them, (2) pushed/shoved, (3) hit with a fist/thrown something that could hurt, (4) choked/burnt them on purpose, (5) threatened them with/ used a gun, and (6) kicked/beaten up.
Emotional violence	PWDs were considered as having emotional violence if PWDs had experienced any one or more of the following indicators in the past year: (1) insulting makes them feel bad about themselves, (2) belittling or humiliating them in front of others, (3) doing things to scare or intimidate them purposely, and (4) threatening to hurt them or
Perceived social support	Participants were asked sixteen five-point Likert scale questions adopted from the multidimensional scale of perceived social support MSPSS^Citation16 to assess perceived social support. Those who scored less than 40 were categorized as having “low perceived social support” and those who scored ≥ 40 were categorized as having “high perceived social support”.
Perceived healthcare access	Participants were asked nine five-point Likert scale questions adopted from previous literature to assess patient-centered access to health services.^Citation17 Those who scored less than 30 were assigned as having “poor perceived access” otherwise, assigned as having “good perceived access”.
Experiencing discrimination by health care providers (HCP)	Participants were asked four five-point Likert scale questions adopted from previous literature.^Citation17 Participants who scored less than 10 were categorized as having “no experience of discrimination” otherwise, categorized as “have experienced discrimination”.
Reliability on others	This was assessed using eight yes/no questions. Yes was scored “1” and no was scored “0”. PWDs with a summary score of ≤ 2 were categorized as having “no reliance on others”, Those with a summary score of 3–5 were categorized as having a “moderate level of reliance” and those who scored ≥6 were categorized as having “severe reliance on others”.

Table 2 Socio-Demographic Characteristics of People with Disabilities in Southern Ethiopia, 2022 (N=645)

Variables	Category	Frequency	Percentage
Age	18–24	57	8.8
	25–34	108	16.7
	35–49	463	71.8
	>49	17	2.6
Sex	Female	335	51.9
Educational status	No formal education	249	38.6
	Primary education	194	30.1
	Secondary education	129	20.1
	Tertiary and above	73	11.3
Occupational status	Unemployed	458	71.0
Marital status	Single	323	50.1
Wealth index	Low	442	68.5
	Medium	124	19.2
	High	79	12.3
With whom living with	Alone	101	15.7
	Family	320	49.6
	Husband/partner	224	34.7
Having children	Yes	290	45.0
Parity	<3	103	16.0
	≥3	76	11.8
Exposure to mass media	Infrequent/not at all	371	57.5
Use of Internet	Infrequent/not at all	503	78.0

Table 3 Behavioral and Disability-Related Characteristics of People with Disabilities in Southern Ethiopia, 2022 (N= 645)

Variable	Category	Frequency	Percentage
Age/onset of disability	During birth and infancy	258	40.0
	1–5 years	56	8.7
	5 years and above	331	51.3
Type of disability	Hearing	157	24.3
	Physical	203	31.5
	Visual	285	44.2
Reliance on the assistance of others for daily activity	Some/not at all	114	17.7
	Moderate	108	16.7
	Severely rely on others	423	65.6
Having low body-esteem	Yes	494	76.6
Perceived social support	Low	349	54.1
Substance/alcohol use	Not at all	59	9.1
	Once a week	23	19.1
	Twice/more in a week	463	71.8
Being a member of any community groups	Yes	318	49.3
Occupied with any humanitarian organization	Yes	445	70.1
Having control of personal affairs	Yes	210	32.6
Knowledge about violence	Good knowledge	203	31.5

Table 4 Perceived Social Support and Health Care Access Among People with Disabilities in Southern Ethiopia, 2022 (N=645)

Items	1 (%)	2 (%)	3 (%)	4 (%)	5 (%)
Perceived social support
Low: 349 (54.1%)
Tangible support items
If you experience violence, there is someone who takes you to the legal bodies	22.2	35.5	14.3	16.0	12.1
If you are sick, there is someone who takes you to the Doctor	25.3	21.4	25.6	11.6	16.1
If you are confined to bed, there is a special person who can provide care for you on an ongoing basis	23.1	36.9	20.9	10.2	8.8
Emotional/informational support
There is a special person with whom I can share my joys and sorrows.	12.1	22.5	12.1	41.1	12.2
I have a special person who is a real source of comfort for me	20.5	22.0	27.6	20.5	9.5
I get the emotional help and support I need from my family	32.6	30.2	19.8	11.3	6.0
I can count on my friends when things go wrong	16.9	20.9	23.3	25.6	13.3
I can talk about my problems with my family	32.6	30.2	19.8	11.3	6.0
There is a special person in my life who cares about my feelings	18.1	20.0	31.0	18.9	12.0
My family is willing to help me make decisions	20.0	24.1	28.1	16.0	11.8
I can talk about my problems with my friends	16.9	20.9	23.3	25.6	13.3
Affectionate support/positive social interaction
There is someone who shows you love and affection	10.5	33.2	25.3	20.9	10.5
There is someone who makes you feel wanted	15.3	36.0	8.1	26.0	14.6
There is someone to get together with for relaxation	15.3	30.9	27.0	11.9	14.9
There is someone to do something enjoyable with	24.0	32.9	22.7	11.3	9.1
There is someone to do things to help you get your mind off	18.3	30.1	20.0	16.4	15.2
Perceived health care access and health care provider’s support; Poor access: 450 (69.8%)
It is easy to get transportation	27.8	31.5	24.7	11.5	4.5
The road networks are not difficult to reach the health facility
There are comfortable toilets in the health facility for people with disability	18.3	26.5	29.3	15.7	10.2
Stretchers and chairs are comfortable	20.0	23.3	25.3	18.6	12.8
There are assistive devices for people with disabilities	29.0	26.4	21.4	17.5	5.7
The beds and toilets are comfortable for PWDs	26.4	21.6	20.0	22.3	9.7
There is a special assistant for people with disabilities	31.0	33.0	20.0	10.9	5.1
I know where to go for counseling if violence happened	19.2	27.1	18.6	29.1	6.0
Health service is user-friendly for people with disability	23.4	28.4	32.9	9.8	5.5
Experience discrimination by health care providers 298 (46.2%)
Health care providers show sympathy for your problems	11.2	14.6	25.4	32.4	16.4
Health care providers do not undermine PWDs	9.7	17.5	25.3	35.2	12.3
Health care providers provide enough information that you need	12.2	18.4	31.6	22.2	15.6
It is easy to communicate with health care providers about a private issue	14.0	19.4	35.8	21.1	9.7

Notes: Key: 1; Strongly disagree; 2 ; Disagree: 3 ; Neutral: 4; Agree: 5: Strongly agree.

Table 5 Prevalence of Violence Against People with Disabilities in Southern Ethiopia, 2022 (N=645)

Types of Violence	Lifetime		Within 12 Months
	n	%	n	%
Emotional violence. Has anyone ever……	406	62.9	385	59.7
Insulted you or made you feel bad about yourself	394	61.1	300	46.5
Did things to scare or intimidate you purposely	350	54.3	232	36.0
Belittled you or humiliated you in front of other people	205	31.8	143	22.2
Threatened to hurt you or someone you care about	148	22.9	55	8.5
Physical violence. Has anyone ever……	323	50.1	60	40.3
Slapped you or threw something at you that could hurt you	277	42.9	210	32.6
Hit you with a fist or with something else that could hurt you	218	33.8	221	34.3
Pushed you or shoved you	134	20.8	101	15.7
Kicked you, dragged you, or beaten you up	100	15.5	187	30.0
Choked or burnt you on purpose	27	4.2	96	14.9
Threatened to use or used a gun, knife, or other weapons against you	19	2.9	50	7.8
Sexual violence. Has anyone ever….	259	40.2	114	17.7
Physically forced you to have sexual intercourse when you did not want to	243	37.8	100	15.5
Forced you to have sexual intercourse you did not want to because you were afraid of what your s/he might do	137	21.2	40	6.2
Force you to do something sexual that you found degrading or humiliating	183	28.4	76	11.8
Any type of violence	486	75.3	395	61.2

Table 6 Factors Associated with Violence Against People with Disabilities in Southern Ethiopia, 2022 (N=645)

Variables	Types of Violence
	Sexual Violence		Physical Violence		Emotional Violence
	COR (95% CI)	AOR (95% CI)	COR (95% CI)	AOR (95% CI)	COR (95% CI)	AOR (95% CI)
Age (RC≤49)
35–49	0.4(0.16,124)
25–34	0.1(0.04,0.50)**
18–24	0.4(0.10,1.19)
Sex (RC=Male)
Female	9.5(5.20,17.34)***	3.5(1.61,7.47)**	1.8(1.29,2.44)***		5.8(4.10,8.20)***	1.9(1.16,3.04)*
Educational status (RC= tertiary and above education)
No formal education	10.0(3.05,32,77)***	4.8(1.18, 19.79)*	3.0(1.67,5.41)***		9.8(5.40,18.00)***	4.9 (1.86,7.78)***
Primary education	3.3(0.97,11.36)		2.0(1.08,3.64)*		4.9(2.68,8.89)***	3.8(2.33,10.18)***
Secondary education	2.4(0.65,8.78)
Marital status ( RC=married)
Single	2.3(1.50, 3.52)***				1.7(1.26,2.38)**
Perceived social support (RC=high)
Low	8.1(4.5114.52)***		2.1(1.49,2.84)***		9.7(6.71,13.99)***	3.0(1.74,5.32)***
Wealth index (RC=high)
Low	1.9(0.95, 3.64)		5.2(2.87,9.6)***	5.4(1.96,15.16)**	3.4(2.10,5.60)***
Medium	0.3(0.09,0.8.)*				2.4(1.33,4.21)**
Substance abuse (RC=not at all)
Once a week	0.5(0.03,7.74)				4.8(2.34,10.02)***
Twice or more in a week	18.5(2.53,106.73)**		4.6(2.25,9.21)***		7.6(3,90,14.66)***
Type of disability (RC= hearing)
Physical	1.0(0.48,2,06)	3.2(1.24,8.12)*
Visual	4.1(2.26,7.60)***	3.5(1.61,7.43)**			2.1(1.40,3.15)***
Reliance on others (RC=not at all)
Some extent	0.4(0.04,3.45)
Severely rely on others	13.3(4.15,42.79)***	5.6(1.34,23.55)*	4.6(2.76,7.64)***	2.9(1.54,5.30)**	2.5(1.67,3.85)***
Being a member of any community group (RC= yes)
No	16.2(8.05,32.77)***	3.9(1.36,11.35)*			9.0(6.20,12.99)***	2.1(114,3.79)*, ^a

Notes: *Statistically significant variables with p-value <0.05,**Statistically significant variables with p-value <0.01, ***Statistically significant variables with p-value <0.00.

Abbreviations: AOR, Adjusted Odds Ratio; CI, Confidence Interval (95%); COR, Crude Odds Ratio; RC, Reference Category.

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