Improving access to healthcare for women in Tanzania by addressing socioeconomic determinants and health insurance: a population-based cross-sectional survey

Bintabara, Deogratius; Nakamura, Keiko; Seino, Kaoruko

dc.creator	Bintabara, Deogratius
dc.creator	Nakamura, Keiko
dc.creator	Seino, Kaoruko
dc.date	2021-05-12T10:36:46Z
dc.date	2021-05-12T10:36:46Z
dc.date	2018
dc.date.accessioned	2022-10-20T14:01:44Z
dc.date.available	2022-10-20T14:01:44Z
dc.identifier	Bintabara, D., Nakamura, K., & Seino, K. (2018). Improving access to healthcare for women in Tanzania by addressing socioeconomic determinants and health insurance: a population-based cross-sectional survey. BMJ open, 8(9), e023013.
dc.identifier	DOI: https://doi.org/10.1136/bmjopen-2018-023013
dc.identifier	http://hdl.handle.net/20.500.12661/3050
dc.identifier.uri	http://hdl.handle.net/20.500.12661/3050
dc.description	Full text article. Also available at https://doi.org/10.1136/bmjopen-2018-023013
dc.description	This study was performed to explore the factors associated with accumulation of multiple problems in accessing healthcare among women in Tanzania as an example of a low-income country. Design Population-based cross-sectional survey. Setting Nationwide representative data for women of reproductive age obtained from the 2015–2016 Tanzania Demographic and Health Survey were analysed. Primary outcome measures A composite variable, problems in accessing healthcare, with five (1-5) categories was created based on the number of problems reported: obtaining permission to go to the doctor, obtaining money to pay for advice or treatment, distance to a health facility and not wanting to go alone. Respondents who reported fewer or more problems placed in lower and higher categories, respectively. A total of 13 266 women aged 15–49 years, with a median age (IQR) of 27 (20–36) years were interviewed and included in the analysis. About two-thirds (65.53%) of the respondents reported at least one of the four major problems in accessing healthcare. Furthermore, after controlling for other variables included in the final model, women without any type of health insurance, those belonging to the poorest class according to the wealth index, those who had not attended any type of formal education, those who were not employed for cash, each year of increasing age and those who were divorced, separated or widowed were associated with greater problems in accessing healthcare. This study indicated the additive effects of barriers to healthcare in low-income countries such as Tanzania. Based on these results, improving uptake of health insurance and addressing social determinants of health are the first steps towards reducing womens problems associated with accessing healthcare.
dc.language	en
dc.publisher	BMJ
dc.subject	Healthcare
dc.subject	Health insurance
dc.subject	Maternal mortality ratio
dc.subject	Healthcare facilities
dc.subject	Maternal health services
dc.subject	Obstetrics care
dc.subject	Antenatal care
dc.title	Improving access to healthcare for women in Tanzania by addressing socioeconomic determinants and health insurance: a population-based cross-sectional survey
dc.type	Article