Health-related quality of life and associated factors among people with disabilities in Northwest Ethiopia

Disability affects a large proportion of the global population, with the majority living in low- and middle -income countries. In Ethiopia, more than 15% of the population living with a disability. Although disability is a major public health concern and significantly affects health-related quality of life (HRQOOL), evidence in Ethiopia remains limited. This study aimed to assess HRQOL and its associated factors among people with disabilities (PWDs) in the North and Central Gondar zones, Northwestern Ethiopia. A systematic random sampling technique was used to select 631 study participants with disabilities in the North and Central Gondar zones. HRQOL was assessed using the 35-item assessment of quality of life-8 dimensions (AQOL-8D). Multivariable logistic regression analysis was used to identify the factors significantly associated with good HRQOL among PWDs. Only 41% of participants reported good HRQOL. Factors significantly associated with higher odds of good HRQOL included being aged 18-25 years (AOR: 1.73, 95%CI: 1.001-2.99) and 26-59 years (AOR: 2.97, 95%CI: 1.48-5.99) compared to those under 18. Participants with primary education higher odds of good HRQOL (AOR: 2.04, 95%CI: 1.14-3.20) than those with no formal education. Employment in private (AOR: 2.16, 95%CI: 1.08-4.30) and government jobs (AOR: 2.93, 95%CI: 1.33-6.43) was also positively associated with HRQOL compared to those being unemployed. Living with parents (AOR: 2.16, 95%CI: 1.08-4.30) or relatives (AOR: 2.93, 95%CI: 1.33-6.43) was associated with good HRQOL than living alone. Access to CBR services (AOR: 2.18, 95% CI: 1.44-329), welcoming healthcare facilities (AOR: 3.96 (95% CI: 1.78-8.77), and independence in ADL (AOR: 5.84 (95%CI: 3.89-8.76) were also significant predictors of HRQOL. Less than half of the participants reported good HRQOL. Factors significantly associated with good HRQOL included age, education, occupation, living arrangements, access to CBR services, welcoming healthcare facilities, and independence in daily activities. These findings highlight the need to expand educational and employment opportunities, strengthening social support systems, improve access to CBR services, and promote inclusive, and respectful healthcare settings. Future research should employ longitudinal designs to better understand casual relationships.