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      Determinants of Access to Health Care Among Women in East African Countries: A Multilevel Analysis of Recent Demographic and Health Surveys from 2008 to 2017

      research-article
      1 , 2
      Risk Management and Healthcare Policy
      Dove
      access, determinants, health care, women, East Africa

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          Abstract

          Background

          Access to essential health care is one of the major factors associated with maternal mortality. In developing countries, improving women’s access to health care has significantly reduced maternal death. Therefore, this study aimed to identify the determinants of access to health care among women in East African countries based on 2008 to 2017 Demographic and Health Surveys (DHSs).

          Methods

          This study used secondary data from 2008 to 2017 DHSs of 12 East African countries. A two-level mixed-effects logistic regression analysis was employed to determine the variables associated with women’s access to maternal health care. The adjusted odds ratios (AORs), 95% CI, and P-value were computed. Variables with P<0.05 were considered as determinants of access to maternal health care.

          Results

          A total of 148,483 study participants were included in this study. Women who accessed health care were 64,218 (42.91%) in the region. The study revealed that access to women’s health care was positively associated with factors; being educated women, having an educated husband, being from households with middle and richest wealth status, and living in different countries compared to Comoros. The study also revealed that living in a rural setting and having unplanned pregnancy were barriers to access to health care.

          Conclusion and Recommendation

          Women in East Africa countries have poor access to maternal health care. Residence, maternal education, husband education, income, and planned pregnancy were the predictors of access to health care. Therefore, there should be a common strategy to enhance the accessibility of health service utilization among women in the region and financial support for the poor that enables women to use health services. For better health care access, increasing the awareness of women and their partners about the significance of utilization of healthcare service focusing on uneducated persons are crucial activities.

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          Most cited references33

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          Gender equality in science, medicine, and global health: where are we at and why does it matter?

          The purpose of this Review is to provide evidence for why gender equality in science, medicine, and global health matters for health and health-related outcomes. We present a high-level synthesis of global gender data, summarise progress towards gender equality in science, medicine, and global health, review the evidence for why gender equality in these fields matters in terms of health and social outcomes, and reflect on strategies to promote change. Notwithstanding the evolving landscape of global gender data, the overall pattern of gender equality for women in science, medicine, and global health is one of mixed gains and persistent challenges. Gender equality in science, medicine, and global health has the potential to lead to substantial health, social, and economic gains. Positioned within an evolving landscape of gender activism and evidence, our Review highlights missed and future opportunities, as well as the need to draw upon contemporary social movements to advance the field.
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            National baselines for the Sustainable Development Goals assessed in the SDG Index and Dashboards

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              Monitoring universal health coverage within the Sustainable Development Goals: development and baseline data for an index of essential health services

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                Author and article information

                Journal
                Risk Manag Healthc Policy
                Risk Manag Healthc Policy
                rmhp
                rmhp
                Risk Management and Healthcare Policy
                Dove
                1179-1594
                30 September 2020
                2020
                : 13
                : 1803-1813
                Affiliations
                [1 ]Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar , Gondar, Ethiopia
                [2 ]Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar , Gondar, Ethiopia
                Author notes
                Correspondence: Amare Minyihun University of Gondar , P.o. Box: 196, Gondar, Ethiopia Email amarebdr@gmail.com
                Author information
                http://orcid.org/0000-0002-7996-6451
                http://orcid.org/0000-0003-3878-7956
                Article
                263132
                10.2147/RMHP.S263132
                7533273
                33061713
                9b694e53-ff4e-429d-8eab-d3c45d397327
                © 2020 Minyihun and Tessema.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 27 May 2020
                : 05 September 2020
                Page count
                Figures: 3, Tables: 4, References: 48, Pages: 11
                Funding
                No funding was acquired for this investigation.
                Categories
                Original Research

                Social policy & Welfare
                access,determinants,health care,women,east africa
                Social policy & Welfare
                access, determinants, health care, women, east africa

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