Factors associated with the perceived barriers of health care access among reproductive-age women in Ethiopia: a secondary data analysis of 2016 Ethiopian demographic and health survey

Tamirat, Koku Sisay; Tessema, Zemenu Tadesse; Kebede, Fentahun Bikale

doi:10.1186/s12913-020-05485-y

Cited by 29 publications

(49 citation statements)

References 22 publications

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“…The predominant barriers were getting money needed for treatment and distance to health facility. This confirms a previous study in Ethiopia by Tessema and Kebede [ 17 ]. The study also showed that women aged 30–34 and 35–39 had lower odds of facing barriers in accessing healthcare, compared to those aged 45 and above.…”

Section: Discussionsupporting

confidence: 92%

“…The prevalence in this study is similar to prevalence of healthcare accessibility barriers reported in South Africa (65%) [ 20 ], Rwanda (64%) [ 18 ], Ethiopia (69%) [ 17 ], and Tanzania (65%) [ 16 ]. The predominant barriers were getting money needed for treatment and distance to health facility.…”

Section: Discussionsupporting

confidence: 85%

“…This is in line with other studies in Ghana [ 30 ], Tanzania [ 16 ], and South Africa [ 20 ] which also found a higher likelihood of barriers to healthcare access in rural areas. The basic explanation could be that, in most parts of SSA, rural areas are less privileged manifesting in less health infrastructure, bad road network, and influence of socio-cultural practices that demand women to seek permission from their partners before seeking healthcare [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

“…companionship, and permission-related barriers, she was considered not to have barriers to healthcare access and coded as "0" [16][17][18]. Independent variables.…”

Section: Plos Onementioning

confidence: 99%

“…Both individual and contextual level factors were considered in this study. These variables were chosen based on their statistically significant association with barriers to healthcare access in previous studies [16][17][18]. The individual level factors included age (15-19, 20-24, 25-29, 30-34, 35-39, 40-44, 45-49), marital status (never married, married, cohabiting, widowed, divorced), educational level (no education, primary, secondary, higher), employment (not working, managerial, clerical, sales, house/domestic, agricultural, services, manual), parity (0,1-3, 4 or more), health insurance subscription (yes, no), and exposure to mass media, specifically, radio, newspaper, and television (not at all, less than once a week, at least once a week, almost every day).…”

Section: Plos Onementioning

confidence: 99%

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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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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

“…companionship, and permission-related barriers, she was considered not to have barriers to healthcare access and coded as "0" [16][17][18]. Independent variables.…”

Section: Plos Onementioning

confidence: 99%

Section: Plos Onementioning

confidence: 99%

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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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Three fourths of women of reproductive age in emerging regions of Ethiopia are facing problems in accessing health care

Fetene

Haile

2023

Sci Rep

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Providing adequate and equal access health care is a key goal towards universal health coverage (UHC), but women continue to confront considerable inequities in accessing healthcare, particularly in the emerging regions of Ethiopia. Therefore, we identified the contributing factors to the problems in accessing health care among women of reproductive age in emerging regions of Ethiopia. Data from the 2016 Ethiopia Demographic and Health Survey were used. A total of 4680 women in reproductive age were included in the final analysis and a multilevel mixed-effect binary logistic regression analysis was done to identify the contributing factors to the problems in accessing health care. In the final model, a p-value of less than 0.05 and adjusted odds ratio (AOR) with 95% confidence interval (CI) were used to declare statistically significant factors. We found that 71.0% (95% CI 69.64–72.24%) of women in reproductive age had problems in accessing health care. Unmarried women (AOR = 1.30 95% CI 1.06–1.59), uneducated (AOR = 2.21 95% CI 1.48–3.30) and attended primary school (AOR = 1.58 95% 1.07–2.32), rural resident (AOR = 2.16 95% CI 1.40–2.02), poor (AOR = 2.95 95% CI 2.25–3.86) and middle wealth status (AOR = 1.74 95% CI 1.27–2.40), women who gave two births (AOR = 1.29 95% CI: 1.02–1.64) and not working (AOR = 1.33 95% CI 1.06, − 1.68) and working in agriculture (AOR = 1.88 95% CI 1.35–2.61) were factors that contributed for the problems in accessing health care. A significant proportion of women of reproductive age in emerging regions of Ethiopia face challenges in accessing healthcare, which places the country far from achieving its UHC targets. This issue is particularly prominent among unmarried, poor and middle wealth status, uneducated, non-working, and rural women of reproductive age. The government should develop strategies to improve women’s education, household wealth status, and occupational opportunities which would help to alleviate the barriers hindering healthcare access for women residing in emerging regions of Ethiopia.

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Spatial distribution and determinants of barriers of health care access among female youths in Ethiopia, a mixed effect and spatial analysis

Fentie,

Asmamaw,

Negash

et al. 2023

Sci Rep

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Access to healthcare services is a fundamental human right for every citizen, and it is the responsibility of the nation to guarantee that these services are acceptable, easily accessible, and timely. Barriers to accessing health services may have a detrimental effect on an individual’s physical, and mental health, and overall quality of life. However, access to health care services is a common problem in developing countries. Therefore, this study aimed to investigate spatial distribution and determinants of barriers to healthcare access among female youths in Ethiopia. Secondary data analysis was conducted based on the Demographic and Health Surveys data conducted in Ethiopia. A total weighted sample of 6143 female youths aged 15–24 years old was included in this study. A mixed-effect analysis was employed to identify factors contributing to barriers to healthcare access among youths in Ethiopia. Adjusted Odds Ratio with 95% CI was used to declare the strength and significance of the association. The concentration index was used to assess wealth-related inequalities, while spatial analysis was used to explore the spatial distribution and significant windows of barriers to healthcare access. This study revealed that the magnitude of barriers to healthcare access among female youth was 61.3% with 95%CI (60.1 to 62.5) to at least one or more of the four reasons. Age 15–19 years old (AOR = 0.80, 95%CI 0.68 to 0.95), no formal education (AOR = 2.26, CI 1.61, 3.18), primary education (AOR = 2.21, CI 1.66, 2.95), marital status (AOR = 1.43, 95% CI 1.21, 1.70), poor household wealth (AOR = 1.63, 95% CI 1.31, 2.05), no Media exposure (AOR = 1.67, 95%CI 1.41–1.98), reside in rural areas (AOR = 1.63, 95%CI 1.05 to 2.54), and low community media exposure (AOR = 1.45, 95%CI 1.01–2.08) were significantly associated with barriers of health care service. Barriers to healthcare access were significantly and disproportionately concentrated in poor households. A non-random Barrier to healthcare access was observed in Ethiopia. Among the 9 regions, primary clusters were identified in only 4 regions (North Ormiya, Benishangul Gumuz, Gambella, and South Nation Nationality and Peoples regions. A significant proportion of female youths faced barriers to health care access Age, educational status, marital status, rural residency, low economic status, and media exposure were factors associated with barriers to health care access. Therefore, program planners and decision-makers should work on improving the country’s economy to a higher economic level to improve the wealth status of the population, promote media exposure, and increase access to education.

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Factors associated with the perceived barriers of health care access among reproductive-age women in Ethiopia: a secondary data analysis of 2016 Ethiopian demographic and health survey

Cited by 29 publications

References 22 publications

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

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

Three fourths of women of reproductive age in emerging regions of Ethiopia are facing problems in accessing health care

Spatial distribution and determinants of barriers of health care access among female youths in Ethiopia, a mixed effect and spatial analysis

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