Barriers to healthcare access among reproductive age women in extremely high and very high maternal mortality countries: Multilevel mixed effect analysis

极高和非常高孕产妇死亡率国家育龄妇女获得医疗保健服务的障碍:多水平混合效应分析

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Abstract

BACKGROUND: It is widely recognized that maternal deaths in low-resource countries are attributed to deprived access to maternal health services. Therefore, the aim of this study was to assess barriers to healthcare access among reproductive age women in extremely high and very high maternal mortality countries. METHODS: A community based cross sectional surveys were conducted among 181,472 reproductive age women. Stata version 17.0 was used to analyze the data. Mixed effect binary logistic regression model was analyzed. Odds ratio along with 95% CI was generated to identify factors associated with barriers to healthcare access. A p-value less than 0.05 was declared as statistical significance. RESULTS: A total of 64.3% (95% CI: 64.06, 64.54) reproductive age women faced barriers to healthcare access. Young age, no formal education, poor wealth index, no media exposure, multiparty, no health insurance coverage, and rural residence were significantly associated with barriers to healthcare access. CONCLUSION: More than six in ten reproductive age women had barriers to healthcare access in extremely high and very high maternal mortality countries. Increasing extensive health education, minimizing financial hardship by expanding health insurance may minimize barriers to healthcare access with attention to rural resident reproductive age women.

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