Barriers to accessing health care among young people in 30 low‐middle income countries

Abstract

Background: Previous studies focusing on high-income countries have shown that young people often face greater barriers to accessing healthcare than older adults.However, in low-middle income countries (LMICs), there have been a paucity of cross-country, quantitative studies highlighting these barriers.Aim: This exploratory study aims to provide a scoping review of the publicly available Demographic and Heath Survey (DHS) data with a view to form the basis for further work.Materials and methods: Data on insurance coverage, agency, and access to evidence-based family planning from 30 countries in the DHS were compared between age groups. Data on 586,250 participants 15-24 years (33% male) and 854,660 participants 25-49 years (16% male) from 30 LMICs were analyzed.Results: Significantly greater barriers to accessing healthcare were observed across six variables in younger population when compared to older adults across all survey questions with an average of 8.4% point difference. Also, there was wide countrylevel variation: the maximum differences between age groups were 33% points; Rwanda was the only country with no age differences.Discussion: This study highlights several possible themes for future research into improving access to healthcare for young people. These themes include more detailed evaluation of country-specific policies to reduced barriers to healthcare for young people and further research into the causative factors that can influence healthcare utilization by young people. Conclusion:Our analysis showcases increased barriers to healthcare access for young people in LMICs. We argue that they can only be improved by targeted policies and direct community engagement.

Socio-Demographic Correlates of Barriers to Access Healthcare Services Among Children in Post-Communist Albania

“…Therefore, it is difficult to compare our quantitative findings related to the prevalence of selfperceived barriers to access healthcare with literature reports. Nevertheless, our findings related to socio-demographic correlates of self-reported barriers to access healthcare services are generally compatible with previous reports from the international literature [7,8,[10][11][12][13]16,[24][25][26]28].…”

“…A recent scoping review reported on the barriers to accessing healthcare among young people in 30 low-middle income countries [25]. Overall, significantly greater barriers to accessing healthcare were reported in the younger populations compared to older adults [25]. Therefore, the available evidence suggests that young people often face additional barriers to accessing healthcare in many low-middle income countries, which resembles findings across many high-income countries [25].…”

“…Of note, most of the studies on this topic have employed a qualitative research methodology and do not provide nationally representative data on the prevalence of barriers to access healthcare services [24]. This is especially the case for studies including children's populations in low-and middle-income countries [25]. Indeed, while there is a significant body of literature across many lowand middle-income which indicate the presence of barriers to healthcare among children and young people [26,27], quantitative data on the prevalence of healthcare access among these population categories are scant, an issue which has been also acknowledged by the Lancet commission on adolescents [28].…”

“…It has been reported that young individuals are less likely to access healthcare compared to other age-groups, and present later when they seek care which results in poor prognosis [25,29]. In addition, there have been several reports from many countries indicating that young people typically report poorer experiences when they access healthcare compared to other groups [30,31].…”

“…A recent scoping review reported on the barriers to accessing healthcare among young people in 30 low-middle income countries [25]. Overall, significantly greater barriers to accessing healthcare were reported in the younger populations compared to older adults [25].…”