Abstract
BACKGROUND: Access to healthcare is vital to women's health outcomes, as emphasised in the Sustainable Development Goals. This study aimed to assess the factors associated with barriers to healthcare utilisation among women aged 15-49 years in Ghana. METHODS: Data from the 2022 Ghana Demographic and Health Survey was used for the study. The study included 15,014 women. Regional variations in the proportion of respondents with healthcare access were visualised using a spatial map. A multivariable binary logistic regression analysis was conducted. The results were presented as adjusted odds ratios (aORs) with 95% confidence intervals (CIs). RESULTS: In Ghana, 53.6% [51.7, 55.5] of women reported barriers to healthcare utilisation. Women aged 25-29 years [aOR = 1.245; 95% CI: 1.01, 1.53] and 45-49 years [aOR = 1.377; 95% CI: 1.04, 1.82] had higher odds of facing barriers in healthcare services utilisation than those aged 15-19 years. The odds for experiencing barriers to healthcare utilisation were higher among women with two [aOR = 1.290; 95% CI: 1.06, 1.56], three [aOR = 1.478; 95% CI: 1.20, 1.82], and four or more children [aOR = 1.306; 95% CI: 1.05, 1.63], women of Ewe [aOR = 1.325; 95% CI: 1.07, 1.63], or Mole Dagbani ethnicity [aOR = 1.512; 95% CI: 1.22, 1.87] compared to those with no children and Akan women respectively. Lower odds were observed among women with higher education [aOR = 0.642; 95% CI: 0.49, 0.84], married [aOR = 0.555; 95% CI: 0.47, 0.66] or cohabiting women [aOR = 0.646; 95% CI: 0.55, 0.76], Muslims [aOR = 0.770; 95% CI: 0.64, 0.92], who watched Television [aOR = 0.776; 95% CI: 0.68, 0.88], and internet users [aOR = 0.765; 95% CI: 0.67, 0.87]. Those in the poorer [aOR = 0.666; 95% CI: 0.54, 0.82], middle [aOR = 0.453; 95% CI: 0.36, 0.58], richer [aOR = 0.368; 95% CI: 0.28, 0.48] and richest [aOR = 0.247; 95% CI: 0.18, 0.34] wealth quintile were less likely to experience barriers to healthcare services utilisation compared to the poorest. Regionally, women in Volta [aOR = 0.478; 95% CI: 0.33, 0.68], Bono [aOR = 0.488; 95% CI: 0.32, 0.76], and Upper East [aOR = 0.382; 95% CI: 0.21, 0.71] regions had lower odds of experiencing barriers to healthcare utilisation than those living in the Western region. CONCLUSION: A higher proportion of women in Ghana experience barriers to healthcare utilisation. Older age, higher parity, higher educational attainment or level, access to media, religion, ethnicity, wealth index, marital status, and geographical region were factors identified to be associated with barriers to healthcare utilisation in Ghana. It is recommended that policymakers prioritise interventions aimed at addressing regional disparities in healthcare infrastructure, improving geographic accessibility to healthcare services, and tackling socioeconomic, cultural, and social determinants of health. Efforts should focus on strengthening community-based healthcare initiatives, strengthening health insurance coverage, and promoting health education and literacy programs. These interventions can enhance health outcomes and promote health equity nationwide.