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Six in ten female youths in low-income East African countries had problems in accessing health care: a multilevel analysis of recent demographic and health surveys from 2016–2021
Authors: Misganaw Guadie Tiruneh, Eneyew Talie Fenta, Destaw Endeshaw, Habitu Birhan Eshetu, Ousman Adal, Abiyu Abadi Tareke, Natnael Kebede, Amare Mebrat Delie, Eyob Ketema Bogale and Tadele Fentabel Anagaw
Source: BMC Health Services Research, Volume 24; DOI:
Topic(s): Health care utilization
Health equity
Women's health
Country: Africa
  Multiple African Countries
Published: APR 2024
Abstract: Background: Access to health care services is a basic human right, and an individual’s health and overall quality of life may suffer as a result of barriers to accessing health services. Access to comprehensive and quality health care is fundamental for promoting and maintaining health, preventing and treating diseases, and reducing premature deaths. However, only half of the African population has access to modern health services. Therefore, this study aimed to assess the health care access and associated factors among female youths in low-income East African countries. Methods: This study used secondary data from 2016 to 2021 demographic and health surveys of 7 low-income East African countries. A total weighted sample of 51,064 youths was included. A multilevel binary logistic regression was employed to identify the associated factors of access to health care since the data has a hierarchical structure. Adjusted Odds Ratio (AOR) with a 95% confidence interval (CI) at a p-value less than 0.05 was used to measure the association of variables whereas Intra-class correlation coefficient (ICC), Median Odds Ratio (MOR), and proportional change in variance (PCV) were used to measure random effects. Result: The overall magnitude of access to healthcare among female youths in low-income East African countries was 38.84% (95% CI: 38.41, 39.26). Youth’s educational level, rich wealth status, media exposure, and community level education were the positive while higher youth’s age and rural residence were the negative predictors of access to healthcare among female youths. Besides, living in different countries compared to Burundi was also an associated factor for accessing healthcare in low-income East African countries. Conclusion: About six in ten female youths were not accessing health care in low-income East African countries. Therefore, to increase healthcare access, health managers and policymakers needed to develop strategies to improve the poor household wealth index, and redistribution of health services for rural residents. The decision-makers and program planners should also work on increasing access to education and media exposure for youths. Further research including health system and quality of service-related factors for accessing healthcare should also be considered by researchers.