Accessibility and predictors of sexual and reproductive health services utilisation among adolescents and youth people with disabilities in Bono Region, Ghana: a cross-sectional survey

BACKGROUND: Despite global commitments to universal health coverage and the Sustainable Development Goals (SDGs), particularly SDGs 3, 4, 5, and 10 by 2030, adolescents and young people with disabilities (AYPWD), including those with long-term physical, sensory, speech, intellectual, or mental impairments, face persistent barriers to accessing sexual and reproductive health (SRH) services (including antenatal care, contraception, family planning) in low- and middle-income countries. Evidence from Ghana remains limited. This study assessed accessibility and predictors of SRH service utilisation among AYPWD aged 15-24 years in Ghana's Bono Region. METHODS: A community-based analytic cross-sectional survey was conducted among 440 AYPWD selected using multi-stage random sampling across urban and rural districts. Data were collected using structured questionnaires capturing sociodemographic characteristics, disability profiles, SRH service utilisation, and structural and perceived accessibility indicators. Descriptive statistics summarised patterns of service use, while logistic regression models identified predictors of SRH service access and perceived ease of access. Statistical significance was set at p < 0.05. RESULTS: Of the 440 respondents, most were female (62.0%), urban residents (80.7%), and aged 20-24 years (52.3%). Access to personal hygiene information was high (82.5%), whereas utilisation of contraceptive information (22.0%), sexually transmitted infection (STI) screening and treatment (32.0%), human immunodeficiency virus (HIV) testing (13.0%), safe abortion information (7.7%), and antenatal care (2.7%) was low. Females had significantly higher odds of accessing contraceptive information (AOR = 4.55; 95% CI: 2.43-8.50; p < 0.001) and menstrual health support (AOR = 13.42; 95% CI: 7.76-23.19; p < 0.001). Respondents with visual (OR = 0.15; 95% CI: 0.09-0.26; p < 0.001) and hearing disabilities (OR = 0.45; 95% CI: 0.25-0.81; p = 0.008) reported greater service-quality barriers, while visual disability was also associated with reduced perceived ease of access (OR = 0.50; 95% CI: 0.29-0.86; p = 0.013). CONCLUSION: SRH service utilisation among AYPWD in the Bono Region remains low and is shaped by gender, disability type, and structural and socioeconomic factors. Strengthening disability-inclusive infrastructure, communication support, gender-responsive programming, and targeted financing mechanisms is essential to improve equitable access and advance progress toward universal health coverage in Ghana.