Prevalence and determinants of modern contraception use among persons with disabilities in low- and middle-income countries: a systematic review and meta-analysis

Abstract

Background Persons with disabilities should require the same level of access to contraception as the general population. However, the extent of contraception use among this group is underexplored in low- and middle-income countries (LMICs). Objective: This study aimed to determine the prevalence of modern contraception use among persons with disabilities in LMICs and identify the key determinants. Methods In June 2024, we conducted a systematic search across six databases to identify studies on disability and modern contraception in LMICs. The primary outcomes were the prevalence of modern contraception use and its determinants among persons with disabilities. Summary estimates were calculated using fixed or random-effects meta-analysis, depending on the level of heterogeneity. Results A total of 19 studies were identified, with 11 included in the meta-analysis. The pooled prevalence of modern contraception use among persons with disabilities was 31.4% (95% CI: 26.5, 36.2), with significant heterogeneity across respondent characteristics. Five factors were significantly associated with higher contraception use: age over 25 years, having some level of education, being in a higher wealth quintile, adequate knowledge of family planning, and being in a formal marital relationship. Conclusion This study reveals a significantly lower prevalence of modern contraception use among persons with disabilities in LMICs. Improving access to education, addressing social norms, and strengthening healthcare systems may contribute to increase contraception access and uptake among persons with disabilities in LMICs.