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

Abstract

Background: Health care access is the timely use of personal health services to achieve the best health outcomes. Problems in accessing health care among reproductive-age may lead to various adverse health outcomes like death and disabilities. Therefore, this study aimed to identify factors associated with the perceived barriers of health care access among reproductive-age women in Ethiopia. Method: This study was based on secondary data sources from the 2016 Ethiopia Demography and Health Survey. From the largest dataset, individual women record (IR) file was used to extract about 15, 683 women for the final analysis. A composite variable of health care access was created from four questions used to rate health care access problems among women of reproductive age. The Generalized Estimating Equation (GEE) model fitted to identify factors associated with perceived barriers of health care access. Crude and adjusted odds ratio (AOR) with a 95% confidence interval (CI) computed to assess the strength of association between independent and outcome variables.Result: This study revealed that the magnitude of perceived barriers of health care access among reproductive-age women found to be 69.9% with 95%CI (69.3 to 70.7) to at least one or more of the four reasons. Rural resident (AOR= 2.13, 95%CI: 1.79 to 2.53), age 35-49 years (AOR= 1.24, 95%CI: 1.09 to 1.40), divorced/separated (AOR= 1.34, 95%CI: 1.17 to 1.54), had no health insurance coverage (AOR=1.19, 95%CI: 1.01 to 1.45), poorer (AOR=2.09,95%CI: 1.86 to 2.35) and middle wealth (AOR=1.57,95%CI:1.38 to 1.79), no education (AOR=2.30, 95%CI:1.95 to 2.72), primary education (AOR= 1.84, 95%CI :1.58 to 2.15) and secondary education (AOR= 1.31, 95%CI: 1.13 to 1.51) were factors associated with the perceived barriers of health care access.Conclusion: A significant proportion of women of reproductive age faced barriers to health care access, of which money and distance were the most frequently perceived barriers. Divorced/separated marital status, old age, rural dwelling, no health insurance coverage, low economic situation, and level of education were factors associated with perceived barriers. These findings suggest further strengthening and improving health care access to those women with low socio-economic status for the realization of universal health coverage.