Factors Influencing Women's access to Healthcare Services in Low- and Middle-Income Countries: A Systematic Review

Abstract

Gender inequalities in accessing healthcare services, particularly in low- and middle-income countries (LMICs) are consistently reported in the literature. Financial constraints and greater distance from healthcare facilities are the most reported barriers to the limited accessibility of women to healthcare services in these countries. However, these two barriers are not specific to women as men living in these countries also face these barriers, then why do gender disparities exist in accessing healthcare services? Objective: To explore this question, we conducted this study to identify factors influencing women’s access to healthcare services in LMICs. Methods: A review article was conducted in September 2023. PubMed, CINHAL, EMBASE and HMIC databases were searched. Additional searching was performed in Google Scholar. Qualitative studies published from the earliest record to August 2023 which reported barriers to women’s access to healthcare services in LMICs were included. Results: Results showed that individual-level factors that influence women’s access to healthcare services in LMICs include economic status and knowledge and beliefs, inter-personal level factors include social norms and support from family and friends, community-level factors include support from community members and transportation facilities while system-level factors that influence women’s access to healthcare services include the availability of healthcare services and providers, the role of the medical fraternity, health insurance coverage, availability and implementation of effective policies and evidence-based practice and research. Conclusion: The review identified a wide range of individual, interpersonal, community and system-level barriers that hinder women residing in LMICs from accessing appropriate healthcare services. There is a need to develop cost-effective, culturally appropriate approaches, guidelines, and policies to improve women’s access to healthcare services in LMICs.