Left behind in primary healthcare: A qualitative exploration of healthcare experiences of people with disabilities in Ethiopia

People with disabilities, who make up 1.3 billion globally, frequently face systemic exclusion from healthcare due to a range of barriers. This qualitative study explored the healthcare access experiences of 30 adults with disabilities in Bahir Dar City, Ethiopia, aiming to identify barriers, facilitators, and context-driven solutions. Both purposive and snowball sampling was conducted to identify participants. In-depth interviews were conducted in the local language. Data were analysed using reflexive thematic analysis in NVivo 14, guided by the Missing Billion Health System Framework service delivery components. The study identified five key themes each for barriers, facilitators, and coping strategies. Major barriers included low health literacy, unaffordable care, negative provider attitudes, inaccessible infrastructure, and lack of assistive technologies and rehabilitation services. Facilitators included family support, community-based health insurance, disability-sensitive training of healthcare workers, presence of a rehabilitation centre, and initiation of renovation infrastructure in model facilities. Participants proposed actionable strategies such as increasing awareness, insurance coverage, local production of assistive technologies, assigning personal assistants in health facilities, improving accessibility, and establishing disability units within governance structures. People with disabilities experienced persistent, intersecting barriers to healthcare access in Ethiopia. However, scaling disability-inclusive training, infrastructure improvemnts, and governance reforms-rooted in lived experience and aligned with human rights of people with disabilities-can help drive progress toward Universal Health Coverage.