Determinants of Access to Health Care Among Women in East African Countries: A Multilevel Analysis of Recent Demographic and Health Surveys from 2008 to 2017

Abstract

Background

Access to essential health care is one of the major factors associated with maternal mortality. In developing countries, improving women’s access to health care has significantly reduced maternal death. Therefore, this study aimed to identify the determinants of access to health care among women in East African countries based on 2008 to 2017 Demographic and Health Surveys (DHSs).

Methods

This study used secondary data from 2008 to 2017 DHSs of 12 East African countries. A two-level mixed-effects logistic regression analysis was employed to determine the variables associated with women’s access to maternal health care. The adjusted odds ratios (AORs), 95% CI, and P-value were computed. Variables with P<0.05 were considered as determinants of access to maternal health care.

Results

A total of 148,483 study participants were included in this study. Women who accessed health care were 64,218 (42.91%) in the region. The study revealed that access to women’s health care was positively associated with factors; being educated women, having an educated husband, being from households with middle and richest wealth status, and living in different countries compared to Comoros. The study also revealed that living in a rural setting and having unplanned pregnancy were barriers to access to health care.

Conclusion and Recommendation

Women in East Africa countries have poor access to maternal health care. Residence, maternal education, husband education, income, and planned pregnancy were the predictors of access to health care. Therefore, there should be a common strategy to enhance the accessibility of health service utilization among women in the region and financial support for the poor that enables women to use health services. For better health care access, increasing the awareness of women and their partners about the significance of utilization of healthcare service focusing on uneducated persons are crucial activities.

Keywords:

• access
• determinants
• health care
• women
• East Africa

Acknowledgments

We would like to thank the measure DHS program for providing the data set.

Abbreviations

AOR, adjusted odds ratio; CI, confidence interval; DHS, Demographic and Health Survey; ICC, intracluster correlation coefficient; MDG, Millennium Development Goal; MOR, median odds ratio; SSA, Sub-Saharan Africa; UHC, universal health coverage; WHO, World Health Organization.

Data Sharing Statement

The data is accessible on the web and you can get to it from www.measuredhs.com.

Ethics Approval and Consent to Participate

The study does not include the assortment of data from subjects. Agree to take part is not pertinent since the study is secondary information investigation dependent on DHS information.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis, and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors announce that they have no conflicts of interest for this work.

Additional information

Funding

No funding was acquired for this investigation.