Barriers to accessing healthcare among women in Ghana: a multilevel modelling

Seidu, Abdul Aziz, Darteh, Eugene Kofuor Maafo, Agbaglo, Ebenezer, Dadzie, Louis Kobina, Ahinkorah, Bright Opoku, Ameyaw, Edward Kwabena, Tetteh, Justice Kanor, Baatiema, Linus, and Yaya, Sanni (2020) Barriers to accessing healthcare among women in Ghana: a multilevel modelling. BMC Public Health, 20. 1916.

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Background: Women’s health remains a global public health concern, as enshrined in the Sustainable Development Goals. This study, therefore, sought to assess the individual and contextual factors associated with barriers to accessing healthcare among women in Ghana.

Methods: The study was conducted among 9370 women aged 15–49, using data from the 2014 Ghana Demographic and Health Survey. Barrier to healthcare, derived from four questions— whether a woman faced problems in getting money, distance, companionship, and permission to see a doctor—was the outcome variable. Descriptive and multilevel logistic regression analyses were carried out. The fixed effect results of the multilevel logistic regression analyses were reported using adjusted odds ratios at a 95% confidence interval.

Results: More than half (51%) of the women reported to have at least one form of barrier to accessing healthcare. Women aged 45–49 (AOR = 0.65, CI: 0.49–0.86), married women (AOR = 0.71, CI:0.58–0.87), those with a higher level of education (AOR = 0.51, CI: 0.37–0.69), those engaged in clerical or sales occupation (AOR = 0.855, CI: 0.74–0.99), and those who were covered by health insurance (AOR = 0.59, CI: 0.53–0.66) had lower odds of facing barriers in accessing healthcare. Similarly, those who listened to radio at least once in a week (AOR =0.77, CI: 0.66–0.90), those who watched television at least once a week (AOR = 0.75, CI: 0.64–0.87), and women in the richest wealth quintile (AOR = 0.47, CI: 0.35–0.63) had lower odds of facing barriers in accessing healthcare. However, women who were widowed (AOR = 1.47, CI: 1.03–2.10), those in the Volta Region (AOR 2.20, CI: I.38–3.53), and those in the Upper West Region (AOR =2.22, CI: 1.32–3.74) had the highest odds of facing barriers to healthcare accessibility.

Conclusion: This study shows that individual and contextual factors are significant in predicting barriers in healthcare access in Ghana. The factors identified include age, marital status, employment, health insurance coverage, frequency of listening to radio, frequency of watching television, wealth status, and region of residence. These findings highlight the need to pay critical attention to these factors in order to achieve the Sustainable Development Goals 3.1, 3.7, and 3.8. It is equally important to strengthen existing strategies to mitigate barriers to accessing healthcare among women in Ghana.

Item ID: 66612
Item Type: Article (Research - C1)
ISSN: 1471-2458
Keywords: Barriers, DHS, Ghana, Global health, Multi-level analysis, Public health, Women’s health
Copyright Information: © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated in a credit line to the data.
Date Deposited: 05 May 2021 04:31
FoR Codes: 42 HEALTH SCIENCES > 4203 Health services and systems > 420311 Health systems @ 100%
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