A descriptive analysis of health practices, barriers to healthcare and the unmet need for cervical cancer screening in the Lower Napo River region of the Peruvian Amazon

Collins, Joseph H.; Bowie, Diana; Shannon, Geordan

doi:10.1177/1745506519890969

Cited by 21 publications

(24 citation statements)

References 27 publications

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“…We further observed that access to mass media showed decreased odds of healthcare accessibility barriers, which confirms previous studies in Ethiopia [47], India [48], Bangladesh [49], and rural Malawi [50]. The reason for this could be that listening to the radio and watching television increases ones' health literacy, which has been identified as key to healthcare utilization [51].…”

Section: Discussionsupporting

confidence: 88%

Barriers to accessing healthcare among women in Ghana: a multilevel modelling

et al. 2020

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Background Women’s health remains a global public health concern, as enshrined 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 Ghana. Methods The study was conducted among 9370 women aged 15–49, using data from the 2014 Ghana Demographic and Health Survey. Barrier to healthcare, derived from four questions— whether a woman faced problems in getting money, distance, companionship, and permission to see a doctor—was the outcome variable. Descriptive and multilevel logistic regression analyses were carried out. The fixed effect results of the multilevel logistic regression analyses were reported using adjusted odds ratios at a 95% confidence interval. Results More than half (51%) of the women reported to have at least one form of barrier to accessing healthcare. Women aged 45–49 (AOR = 0.65, CI: 0.49–0.86), married women (AOR = 0.71, CI:0.58–0.87), those with a higher level of education (AOR = 0.51, CI: 0.37–0.69), those engaged in clerical or sales occupation (AOR = 0.855, CI: 0.74–0.99), and those who were covered by health insurance (AOR = 0.59, CI: 0.53–0.66) had lower odds of facing barriers in accessing healthcare. Similarly, those who listened to radio at least once in a week (AOR =0.77, CI: 0.66–0.90), those who watched television at least once a week (AOR = 0.75, CI: 0.64–0.87), and women in the richest wealth quintile (AOR = 0.47, CI: 0.35–0.63) had lower odds of facing barriers in accessing healthcare. However, women who were widowed (AOR = 1.47, CI: 1.03–2.10), those in the Volta Region (AOR 2.20, CI: I.38–3.53), and those in the Upper West Region (AOR =2.22, CI: 1.32–3.74) had the highest odds of facing barriers to healthcare accessibility. Conclusion This study shows that individual and contextual factors are significant in predicting barriers in healthcare access in Ghana. The factors identified include age, marital status, employment, health insurance coverage, frequency of listening to radio, frequency of watching television, wealth status, and region of residence. These findings highlight the need to pay critical attention to these factors in order to achieve the Sustainable Development Goals 3.1, 3.7, and 3.8. It is equally important to strengthen existing strategies to mitigate barriers to accessing healthcare among women in Ghana.

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Section: Discussionsupporting

confidence: 88%

Barriers to accessing healthcare among women in Ghana: a multilevel modelling

et al. 2020

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“…Exposure to mass media also showed decreased odds of healthcare accessibility barriers, which corroborates earlier studies in Ethiopia [40], India [41], Bangladesh [42], and rural Malawi [43]. The reason for this could be that listening to radio, reading newspaper, and watching television increase ones' health literacy, which has been identified as a key enabler to healthcare utilization [44].…”

Section: Plos Onesupporting

confidence: 85%

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

Seidu

2020

PLoS ONE

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Background 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). Materials and methods 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. Results 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. Conclusion 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.

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“…Another study focusing on unmet needs in Brazil found that financial reasons, long waiting times and lack of professionals and services were main reasons for forgoing appropriate care (31). Qualitative research further indicates that factors associated with poorer access are interconnected, such that people experiencing multiple vulnerability factors may have even greater barriers to health services, which require coordinated action of multiple sectors beyond health (32)(33)(34)(35).…”

Section: Discussionmentioning

confidence: 99%

Leveraging household survey data to measure barriers to health services access in the Americas

Báscolo

Houghton

Riego

2020

Revista Panamericana De Salud Pública

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Objective. To identify advantages and challenges of using household survey data to measure access barriers to health services in the Americas and to report findings from most recent surveys. Methods. Descriptive cross-sectional study using data retrieved from publicly available nationally representative household surveys carried out in 27 countries of the Americas. Values for indicators of access barriers for forgone care were generated using available datasets and reports from the countries. Results were disaggregated by wealth quintiles according to income or asset-based wealth levels. Results. Most surveys were similar in general approach and in the categories of their content. However, country-specific questionnaires varied by country, which hindered cross-country comparisons. On average, about one-third of people experienced multiple barriers to forgone appropriate care. There was great variability between countries in the experience of these barriers, although disparities were relatively consistent across countries. People in the poorest wealth quintile were more likely to experience barriers related to acceptability issues, financial and geographic access, and availability of resources. Conclusions. The analysis indicates major inequalities by wealth status and uneven progress in multiple access barriers that hinder progress towards the goals of equity as part of the Sustainable Development Goals and universal health in the Americas. Access barriers were multiple, which highlights the need for integrated and multisectoral approaches to tackle them. Given the variability between instruments across countries, future efforts are needed to standardize questionnaires and improve data quality and availability for regional monitoring of access barriers.

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A descriptive analysis of health practices, barriers to healthcare and the unmet need for cervical cancer screening in the Lower Napo River region of the Peruvian Amazon

Cited by 21 publications

References 27 publications

Barriers to accessing healthcare among women in Ghana: a multilevel modelling

Barriers to accessing healthcare among women in Ghana: a multilevel modelling

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

Leveraging household survey data to measure barriers to health services access in the Americas

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