Barriers to healthcare access and healthcare seeking for childhood illnesses among childbearing women in sub-Saharan Africa: A multilevel modelling of Demographic and Health Surveys

Bright Opoku AHINKORAH, Eugene BUDU*, Abdul Aziz SEIDU, Ebenezer AGBAGLO, Collins ADU, Edward Kwabena AMEYAW, Irene Gyamfuah AMPOMAH, Anita Gracious ARCHER, Kwaku KISSAH-KORSAH, Sanni YAYA

*Corresponding author for this work

Research output: Journal PublicationsJournal Article (refereed)peer-review

8 Citations (Scopus)

Abstract

Introduction

The success of current policies and interventions on providing effective access to treatment for childhood illnesses hinges on families’ decisions relating to healthcare access. In sub-Saharan Africa (SSA), there is an uneven distribution of child healthcare services. We investigated the role played by barriers to healthcare accessibility in healthcare seeking for childhood illnesses among childbearing women in SSA.

Materials and methods

Data on 223,184 children under five were extracted from Demographic and Health Surveys of 29 sub-Saharan African countries, conducted between 2010 and 2018. The outcome variable for the study was healthcare seeking for childhood illnesses. The data were analyzed using Stata version 14.2 for windows. Chi-square test of independence and a two-level multivariable multilevel modelling were carried out to generate the results. Statistical significance was pegged at p<0.05. We relied on ‘Strengthening the Reporting of Observational Studies in Epidemiology’ (STROBE) statement in writing the manuscript.

Results

Eighty-five percent (85.5%) of women in SSA sought healthcare for childhood illnesses, with the highest and lowest prevalence in Gabon (75.0%) and Zambia (92.6%) respectively. In terms of the barriers to healthcare access, we found that women who perceived getting money for medical care for self as a big problem [AOR = 0.81 CI = 0.78–0.83] and considered going for medical care alone as a big problem [AOR = 0.94, CI = 0.91–0.97] had lower odds of seeking healthcare for their children, compared to those who considered these as not a big problem. Other factors that predicted healthcare seeking for childhood illnesses were size of the child at birth, birth order, age, level of community literacy, community socio-economic status, place of residence, household head, and decision-maker for healthcare.

Conclusion

The study revealed a relationship between barriers to healthcare access and healthcare seeking for childhood illnesses in sub-Saharan Africa. Other individual and community level factors also predicted healthcare seeking for childhood illnesses in sub-Saharan Africa. This suggests that interventions aimed at improving child healthcare in sub-Saharan Africa need to focus on these factors.

Original languageEnglish
Article numbere0244395
Number of pages16
JournalPLoS ONE
Volume16
Issue number2
DOIs
Publication statusE-pub ahead of print - 8 Feb 2021
Externally publishedYes

Bibliographical note

We acknowledge Measure DHS for providing us with the data upon which the findings of this study were based.

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