scholarly journals Determinants of Women Access to Healthcare Services in Sub-Saharan Africa

2019 ◽  
Vol 12 (1) ◽  
pp. 504-514 ◽  
Author(s):  
Azuh Dominic ◽  
Adeyemi Ogundipe ◽  
Oluwatomisin Ogundipe

Background: The study examined the socio-economic determinants of women access to healthcare services in Sub-Saharan Africa for the period 1995-2015. Methods: The study adopted the dynamic panel model and estimated it using the System Generalized Method of Moments in a bid to overcome the endogeneity problem inherent in the model of study. Result: The study harmonized the theoretical strands in the literature by describing the measure of access determinants as three main components; i. Health service availability, ii. Health service utilization and iii. Health service decision. Conclusion: The indicators of health service availability such as community health workers, physicians, nurses and midwives and hospital beds improve women's access to healthcare facilities in Africa. Also, health service utilization indicators such as population density worsen the quality of healthcare services available to women while electricity access and private health expenditure enhance women’s access to quality healthcare delivery. Health service decision indicators such as female bank account ownership, female labour force participation, attainment of basic education and female household headship were important in enhancing women's access to healthcare facilities. Generally, women's health outcomes were more responsive to health service utilization; implying that service utilization is an important proof of healthcare access in Africa.

Author(s):  
Pascal Geldsetzer ◽  
Marcel Reinmuth ◽  
Paul O Ouma ◽  
Sven Lautenbach ◽  
Emelda A Okiro ◽  
...  

Background: SARS-CoV-2, the virus causing coronavirus disease 2019 (COVID-19), is rapidly spreading across sub-Saharan Africa (SSA). Hospital-based care for COVID-19 is particularly often needed among older adults. However, a key barrier to accessing hospital care in SSA is travel time. To inform the geographic targeting of additional healthcare resources, this study aimed to determine the estimated travel time at a 1km x 1km resolution to the nearest hospital and to the nearest healthcare facility of any type for adults aged 60 years and older in SSA. Methods: We assembled a unique dataset on healthcare facilities' geolocation, separately for hospitals and any type of healthcare facility (including primary care facilities) and including both private- and public-sector facilities, using data from the OpenStreetMap project and the KEMRI Wellcome Trust Programme. Population data at a 1km x 1km resolution was obtained from WorldPop. We estimated travel time to the nearest healthcare facility for each 1km x 1km raster using a cost-distance algorithm. Findings: 9.6% (95% CI: 5.2% - 16.9%) of adults aged 60 and older years had an estimated travel time to the nearest hospital of longer than six hours, varying from 0.0% (95% CI: 0.0% - 3.7%) in Burundi and The Gambia, to 40.9% (95% CI: 31.8% - 50.7%) in Sudan. 11.2% (95% CI: 6.4% - 18.9%) of adults aged 60 years and older had an estimated travel time to the nearest healthcare facility of any type (whether primary or secondary/tertiary care) of longer than three hours, with a range of 0.1% (95% CI: 0.0% - 3.8%) in Burundi to 55.5% (95% CI: 52.8% - 64.9%) in Sudan. Most countries in SSA contained populated areas in which adults aged 60 years and older had a travel time to the nearest hospital of more than 12 hours and to the nearest healthcare facility of any type of more than six hours. The median travel time to the nearest hospital for the fifth of adults aged 60 and older years with the longest travel times was 348 minutes (IQR: 240 - 576 minutes) for the entire SSA population, ranging from 41 minutes (IQR: 34 - 54 minutes) in Burundi to 1,655 minutes (IQR: 1065 - 2440 minutes) in Gabon. Interpretation: Our high-resolution maps of estimated travel times to both hospitals and healthcare facilities of any type can be used by policymakers and non-governmental organizations to help target additional healthcare resources, such as new make-shift hospitals or transport programs to existing healthcare facilities, to older adults with the least physical access to care. In addition, this analysis shows precisely where population groups are located that are particularly likely to under-report COVID-19 symptoms because of low physical access to healthcare facilities. Beyond the COVID-19 response, this study can inform countries' efforts to improve care for conditions that are common among older adults, such as chronic non-communicable diseases.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Jialing Qiu ◽  
Duo Song ◽  
Juan Nie ◽  
Mengyi Su ◽  
Chun Hao ◽  
...  

Abstract Background The number of Chinese migrants in Sub-Saharan Africa (SSA) is increasing, which is part of the south-south migration. The healthcare seeking challenges for Chinese migrants in Africa are different from local people and other global migrants. The aim of this study is to explore utilization of local health services and barriers to health services access among Chinese migrants in Kenya. Methods Thirteen in-depth interviews (IDIs) and six focus group discussions (FGDs) were conducted among Chinese migrants (n = 32) and healthcare-related stakeholders (n = 3) in Nairobi and Kisumu, Kenya. Data was collected, transcribed, translated, and analyzed for themes. Results Chinese migrants in Kenya preferred self-treatment by taking medicines from China. When ailments did not improve, they then sought care at clinics providing Traditional Chinese Medicine (TCM) or received treatment at Kenyan private healthcare facilities. Returning to China for care was also an option depending on the perceived severity of disease. The main supply-side barriers to local healthcare utilization by Chinese migrants were language and lack of health insurance. The main demand-side barriers included ignorance of available healthcare services and distrust of local medical care. Conclusions Providing information on quality healthcare services in Kenya, which includes Chinese language translation assistance, may improve utilization of local healthcare facilities by Chinese migrants in the country.


2021 ◽  
Author(s):  
Sepali Guruge ◽  
Souraya Sidani ◽  
Vathsala Illesinghe ◽  
Rania Younes ◽  
Huda Bukhari ◽  
...  

Objective Access to healthcare is an important part of the (re)settlement process for Syrian refugees in Canada. There is growing concern about the healthcare needs of the 54,560 Syrian refugees who were admitted to Canada by May 2018, 80% of whom are women and children. We explored the healthcare needs of newcomer Syrian women, their experiences in accessing and using health services, and the factors and conditions that shape whether and how they access and utilize health services in the Greater Toronto Area (GTA). Method This community-based qualitative descriptive interpretive study was informed by Yang & Hwang (2016) health service utilization framework. Focus group discussions were held with 58 Syrian newcomer women in the GTA. These discussions were conducted in Arabic, audio-recorded with participants’ consent, translated into English and transcribed, and analyzed using thematic analysis. Results Participants’ health concerns included chronic, long-term conditions as well as new and emerging issues. Initial health insurance and coverage were enabling factors to access to services, while language and social disconnection were barriers. Other factors, such as beliefs about naturopathic medicine, settlement in suburban areas with limited public transportation, and lack of linguistically, culturally, and gender-appropriate services negatively affected access to and use of healthcare services. Conclusion Responding to the healthcare needs of Syrian newcomer women in a timely and comprehensive manner requires coordinated, multi-sector initiatives that can address the financial, social, and structural barriers to their access and use of services.


2021 ◽  
Author(s):  
Sepali Guruge ◽  
Souraya Sidani ◽  
Vathsala Illesinghe ◽  
Rania Younes ◽  
Huda Bukhari ◽  
...  

Objective Access to healthcare is an important part of the (re)settlement process for Syrian refugees in Canada. There is growing concern about the healthcare needs of the 54,560 Syrian refugees who were admitted to Canada by May 2018, 80% of whom are women and children. We explored the healthcare needs of newcomer Syrian women, their experiences in accessing and using health services, and the factors and conditions that shape whether and how they access and utilize health services in the Greater Toronto Area (GTA). Method This community-based qualitative descriptive interpretive study was informed by Yang & Hwang (2016) health service utilization framework. Focus group discussions were held with 58 Syrian newcomer women in the GTA. These discussions were conducted in Arabic, audio-recorded with participants’ consent, translated into English and transcribed, and analyzed using thematic analysis. Results Participants’ health concerns included chronic, long-term conditions as well as new and emerging issues. Initial health insurance and coverage were enabling factors to access to services, while language and social disconnection were barriers. Other factors, such as beliefs about naturopathic medicine, settlement in suburban areas with limited public transportation, and lack of linguistically, culturally, and gender-appropriate services negatively affected access to and use of healthcare services. Conclusion Responding to the healthcare needs of Syrian newcomer women in a timely and comprehensive manner requires coordinated, multi-sector initiatives that can address the financial, social, and structural barriers to their access and use of services.


Author(s):  
Kevin KC Hung ◽  
Joseph H. Walline ◽  
Emily Ying Yang Chan ◽  
Zhe Huang ◽  
Eugene Siu Kai Lo ◽  
...  

Background: As health systems across the world respond to the coronavirus disease 2019 (COVID-19), there is rising concern that patients without COVID-19 are not receiving timely emergency care, resulting in avoidable deaths. This study examined patterns of self-reported health service utilization, their socio-demographic determinants and association with avoidable deaths during the COVID-19 outbreak. Methods: A cross-sectional telephone survey was conducted between March 22 and April 1, 2020, during the peak rise in confirmed COVID-19 cases in Hong Kong. Cantonese-speaking Hong Kong residents over 18-years-old were recruited using a computerised random digital dialling (RDD) system. The RDD method used stratified random sampling to ensure a representative sample of the target population by age, gender, and residential district. A structured self-reported questionnaire was used. Results: Out of 1738 placed calls, 765 subjects responded to the questionnaire (44.0% response rate). The factors associated with avoiding medical consultation included being female (37.2% vs. 22.5%, P<.001), married (32.8% vs. 27%, P=.044), completing tertiary education (35.3% vs. 27.7% (secondary) vs. 14.8% (primary), P=.005), and those who reported a "large/very large" impact of COVID-19 on their mental health (36.1% vs 30.5% (neutral) vs. 19.7% (very small/small), P=.047) using logistic regression analysis. Conclusion: Married females with both higher educational attainment and concern about COVID-19 were associated with avoiding healthcare services. Timely public communication to encourage and promote early health seeking treatment even during extreme events such as pandemics are needed.


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