Journal Article

Mixed effects analysis of factors associated with barriers to accessing healthcare among women in sub-Saharan Africa: Insights from demographic and health surveys

Seidu, Abdul-Aziz

2020

Overview

Access to healthcare is one of the key global concerns as treasured in the Sustainable Development Goals. This study, therefore, sought to assess the individual and contextual factors associated with barriers to accessing healthcare among women in sub-Saharan Africa (SSA). Data for this study were obtained from the latest Demographic and Health Surveys (DHS) conducted between January 2010 and December 2018 across 24 countries in SSA. The sample comprised 307,611 women aged 15-49. Data were analysed with STATA version 14.2 using both descriptive and multilevel logistic regression modelling. Statistical significance was set at p<0.05. It was found that 61.5% of women in SSA face barriers in accessing healthcare. The predominant barriers were getting money needed for treatment (50.1%) and distance to health facility (37.3%). Women aged 35-39 (AOR = 0.945, CI: 0.911-0.980), married women (AOR = 0.694, CI: 0.658-0.732), richest women (AOR = 0.457, CI:0.443-0.472), and those who read newspaper or magazine at least once a week (AOR = 0.893, CI:0.811-0.983) had lower odds of facing barriers in accessing healthcare. However, those with no formal education (AOR = 1.803, CI:1.718-1.891), those in manual occupations (AOR = 1.551, CI: 1.424-1.689), those with parity 4 or more (AOR = 1.211, CI: 1.169-1.255), those who were not covered by health insurance (AOR = 1.284, CI: 1.248-1.322), and those in rural areas (AOR = 1.235, CI:1.209-1.26) had higher odds of facing barriers to healthcare access. Both individual and contextual factors are associated with barriers to healthcare accessibility in SSA. Particularly, age, marital status, employment, parity, health insurance coverage, exposure to mass media, wealth status and place of residence are associated with barriers to healthcare accessibility. These factors ought to be considered at the various countries in SSA to strengthen existing strategies and develop new interventions to help mitigate the barriers. Some of the SSA African countries can adopt successful programs in other parts of SSA to suit their context such as the National Health Insurance Scheme (NHIS) and the Community-based Health Planning and Services concepts in Ghana.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Accessibility / Adolescent / Adult / Africa South of the Sahara / Analysis / Community planning / Datasets / Demographics / Demography / Earth Sciences / Education / Factor Analysis, Statistical / Female / Health care / Health care access / Health care disparities / Health care facilities / Health care services accessibility / Health facilities / Health insurance / Health planning / Health Services Accessibility / Health Surveys / Humans / Insurance / Insurance coverage / Logistic Models / Low income groups / Marital status / Mass media / Maternal & child health / Mathematical models / Medicine and Health Sciences / Middle Aged / Multilevel Analysis / News media / Parity / People and Places / Polls & surveys / Regression analysis / Rural areas / Sample Size / Social Sciences / Socioeconomics / Statistical analysis / Surveys / Sustainable development / Variables / Women patients / Womens health / Young Adult