“I Know That Clinic Isn’t Meant for Me”: Barriers to Primary Health Care for Adults with Physical Disabilities in Rural Ethiopia—A Critical Disability Theory Perspective

Access to health care is a fundamental human right established in various legal frameworks worldwide. However, increasing evidence indicates that individuals with physical disabilities in rural Ethiopia continue to face barriers and disparities in accessing health care, leading to unmet needs and worsening health. Guided by Critical Disability Theory and Intersectionality Theory, this instrumental case study explored the barriers to accessing primary health care (PHC) for adults with physical disabilities in rural Ethiopia and examined how disability intersects with poverty, gender, and rurality to shape exclusion. Following purposeful sampling, we conducted 14 interviews and one focus group discussion (n = 7) with adults with physical disabilities, supplemented by PHC facility infrastructure observation. Using reflexive thematic analysis, we identified intersecting barriers across four domains: physical and environmental barriers, socioeconomic marginalization, socio-cultural stigma and attitudinal barriers, and systemic weaknesses in health service delivery. This revealed that disability-related barriers are rooted in structural ableism and intersecting inequities, underscoring the urgent need for inclusive policies and disability-inclusive practices. Such practices include enforcing accessibility standards, expanding community-based health insurance to cover disability-specific needs, supporting transportation, and providing disability-specific training for health professionals. Implementing these practices is essential to advancing disability rights and ensuring equitable health access in Ethiopia.