Association between the Survey-based Women's Empowerment (SWPER) index and barriers to healthcare in sub-Saharan Africa
Aboagye, Richard Gyan, Essuman, Mainprice Akuoko, Salihu, Tarif, Seidu, Abdul-Aziz, Hagan, John Elvis, Baiden, Frank, and Ahinkorah, Bright Opoku (2025) Association between the Survey-based Women's Empowerment (SWPER) index and barriers to healthcare in sub-Saharan Africa. International Health, 17 (5). pp. 734-744.
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Abstract
Background: Women's health is an essential component of the Sustainable Development Goals. We examined how women's empowerment influences barriers to healthcare access in sub-Saharan Africa. Methods: The study included a weighted sample of 188 572 women's data from the Demographic and Health Surveys of 21 countries. A multilevel binary logistic regression analysis was used to examine the association between women's empowerment and barriers to accessing healthcare. Results: Women in the medium and high categories of attitude towards violence, social independence and autonomy were less likely to experience problems in getting permission to go for treatment. Women who had high attitudes towards violence were less likely to experience problems in getting money for treatment. Women with high social independence were less likely to face problems getting money for treatment. Women with high scores for attitudes towards violence, social independence and decision-making had the lowest likelihood of experiencing difficulty with distance to a health facility. Similarly, those in the high categories for attitude towards violence, social independence and decision-making had the lowest odds of experiencing problems not wanting to go alone. Conclusions: Women's empowerment decreases the barriers to accessing healthcare in sub-Saharan Africa. Designing healthcare intervention programs for women should consider the contribution that women make to household decision-making, social independence and attitudes towards violence.
| Item ID: | 89000 |
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| Item Type: | Article (Research - C1) |
| ISSN: | 1876-3405 |
| Keywords: | barriers, healthcare access, SWPER, women's empowerment |
| Copyright Information: | © The Author(s) 2025. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. |
| Date Deposited: | 29 Oct 2025 23:29 |
| FoR Codes: | 42 HEALTH SCIENCES > 4206 Public health > 420606 Social determinants of health @ 100% |
| SEO Codes: | 20 HEALTH > 2005 Specific population health (excl. Indigenous health) > 200509 Women's and maternal health @ 50% 20 HEALTH > 2004 Public health (excl. specific population health) > 200499 Public health (excl. specific population health) not elsewhere classified @ 50% |
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