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

Figures & data

Figure 1 Map of Africa and Eastern African Regions to study access to health care in East Africa Region, 2020.

Figure 2 Access to health care in the East African Countries from 2008 to 2017.

Figure 3 Overall access to health care in the East African Regions from 2008 to 2017 recent Demographic and Health Surveys.

Table 1 Individual and Country-Level Characteristics of Accessing Health Care in East Africa Countries Recent Demographic and Health Surveys from 2008 to 2017

Variables	Frequency	Percentage (%)
Accessing health care (148,483) outcome
Big problem	84,269	57.09
Not big problem	64,218	42.91
Country (148,483)
Burundi	13,610	9.62
Ethiopia	11,022	7.79
Kenya	19,563	13.83
Comoros	2880	2.04
Madagascar	12,407	8.77
Malawi	17,395	12.29
Mozambique	11,477	8.11
Rwanda	8002	5.66
Tanzania	10,051	7.10
Uganda	15,270	10.79
Zambia	13,383	9.46
Zimbabwe	6418	4.54
Residence (148,483)
Urban	31,012	21.92
Rural	110,471	78.08
Age group (148,483)
<20	42,166	29.80
20–34	67,107	47.85
35–49	31,612	22.34
Marital status (148,483)
Single	41,222	29.14
Married	100,261	70.86
Maternal education (148,471)
No education	33,619	23.76
Primary	75,945	53.68
Secondary	27,199	19.23
Higher	4704	3.33
Partner Education (118,340)
No education	25,268	21.35
Primary	59,332	50.14
Secondary	27,692	23.40
Higher	6692	5.11
Literacy (141,400)
Cannot read	53,621	37.92
Can read	87,779	62.08
Maternal Occupation
Had occupation	36,830	28.08
Had no occupation	94,330	71.92
Wealth Index
Poor	64,367	45.49
Middle	27,586	19.50
Rich	49,528	35.01
Pregnancy wanted (131,215)
Yes	121,189	92.36
No	10,026	7.64

Table 2 Multivariable Multilevel Logistic Regression Analysis of Both Individual and Community-Level Factors Associated with Accessing Health Care in East Africa Countries from 2008 to 2017

Variables	Null Model AOR (95% CI)	Individual-Level Model 1 AOR (95% CI)	Country-Level Model 2 AOR (95% CI)	Full Model 3 (Individual+Country) AOR (95% CI)
Residence
Urban		1		1
Rural		0.57 (0.55,059)		0.58 (0.56,0.60)**
Age group
<20		1		1
20–34		0.96 (0.93,1.01)		0.96 (0.93,1.03)
35–49		0.96 (0.91,1.01)		0.96 (0.92,1.01)
Marital status
Single		1		1
Married		1.05 (0.99,1.02)		1.07 (0.99,1.10)
Maternal education
No education		1
Primary		1.09 (1.05,1.13)		1.06 (1.01,1.10)*
Secondary		1.27 (1.20,1.35)		1.22 (1.15,1.29)*
Higher		1.92 (1.73,2.14)		1.84 (1.66,2.05)*
Partner education
No education		1		1
Primary		1.10 (1.06,1.14)		1.08 (1.05,1.12)*
Secondary		1.29 (1.23,1.31)		1.26 (1.20,1.31)**
Higher		1.69 (1.57,1.82)		1.66 (1.54,1.79)***
Literacy
Cannot read		1		1
Can read		1.10 (1.06,1.14)		1.12 (1.08,1.16)*
Maternal occupation
Had occupation		1		1
Had no occupation		1.03 (1.00,1.06)		1.03 (0.99,1.06)
Wealth index
Poor		1		1
Middle		1.43 (1.38,1.48)		1.44 (1.39,1.49)*
Rich		2.27 (2.20,2.35)		2.30 (2.23,2.38)***
Pregnancy wanted
Yes		1		1
No		0.87 (0.83,0.92)		0.88 (0.83,0.93)*
Country
Burundi			1.27 (1.15,1.39)	1.60 (1.44,1.78)*
Ethiopia			1.20 (1.09,1.33)	1.55 (1.40,1.73)*
Kenya			9.18 (8.33,10.11)	2.75 (2.47,3.06)**
Comoros			1	1
Madagascar			5.62 (5.11,6.19)	7.62 (6.87,8.40)*
Malawi			1.38 (1.26,1.52)	1.50 (135,1.66)*
Mozambique			1.90 (1.72,2.09)	1.96 (1.77,2.18)*
Rwanda			2.05 (1.86,2.27)	2.47 (2.21,2.77)*
Tanzania			1.54 (1.39,1.70)	1.83 (1.64,2.03)*
Uganda			1.87 (1.71,2.06)	2.30 (2.07,2.55)*
Zambia			2.82 (2.56,3.09)	2.83 (2.55,3.13)*
Zimbabwe			2.37 (2.09,2.56)	1.69 (1.51,1.93)*
Random effect parameters
ICC%	99%
PCV%	Referrence	65%	56%	75%
MOR	4.22	3.22	2.98	2.44
Model comparison
LLR	−90,165	−70,558	−90,123	−70,539
Deviance	180,330	141,116	180,246	141,078

Notes: *Significant at P-value < 0.05, **Significant at P-value, 0.01, ***Significant at P-value 0.001.

Abbreviations: CI, confidence interval; AOR, adjusted odds ratio; ICC, intraclass correlation coefficient; PCV, proportional change in variance; MOR, median odds ratio; and LLR, log-likelihood ratio.