Department of Public Health, Ambo University, Ambo, Ethiopia
Human Physiology, University of Gondar, Gondar, Ethiopia.
BMJ Open. 2023 Aug 2;13(8):e073491. doi: 10.1136/bmjopen-2023-073491.
To assess problems with accessing healthcare and its associated factors among reproductived-age women in the Gambia using the Gambia Demographic and Health Survey 2019/2020.
A community-based cross-sectional study.
This study was based on a large, community-based cross-sectional survey, conducted from 2019 to 2020 in the Gambia. The survey employed a stratified two-stage cluster sampling technique to recruit study participants. Descriptive statistics and logistic regression models were used to summarise descriptive data and identify factors associated with problems of accessing healthcare, respectively. A p value of less than 0.05 and 95% CI were used to determine statistical significance.
A total of 11 865 reproductive-aged women (15-49 years) were included in the study. The mean age of the women was 28.21 with an SD of 9.33 and ranges 15-49 years. Regarding marital status, 7526 (63.43%) were married.
The magnitude of problems with accessing healthcare among reproductive-aged women in the Gambia was 45.5% (95% CI: 44.6%, 46.4%). Age (adjusted OR (AOR)=1.48, 95% CI: 1.12, 1.95), being from rural residence (AOR=1.28, 95% CI: 1.07, 1.53), parity (AOR=1.07, 95% CI: 1.03, 1.12), middle (AOR=0.54, 95% CI: 0.46, 0.64) and greater wealth (AOR=0.30, 95% CI: 0.25, 0.37), giving birth at health institutions (AOR=0.69, 95% CI: 0.58, 0.80), currently working (AOR=0.77, 95% CI: 0.68, 0.86) and geographical region were significantly associated with problems of accessing healthcare.
Problems of accessing healthcare among women of reproductive age were high in the Gambia. Age, region, working status, parity, residence, wealth and place of delivery were the identified factors associated with problems of accessing healthcare. Policymakers and public health experts should consider those factors while designing maternal healthcare programmes. Affordable healthcare service programmes should be designed to increase healthcare access in the Gambia.
利用 2019-2020 年冈比亚人口与健康调查数据，评估冈比亚育龄妇女获得医疗保健服务的问题及其相关因素。
基于社区的横断面研究。
本研究基于一项大型社区横断面调查，于 2019 年至 2020 年在冈比亚进行。该调查采用分层两阶段聚类抽样技术招募研究参与者。采用描述性统计和逻辑回归模型分别总结描述性数据和识别与获得医疗保健服务问题相关的因素。p 值<0.05 和 95%置信区间用于确定统计学意义。
共有 11865 名育龄妇女（15-49 岁）纳入研究。女性的平均年龄为 28.21 岁，标准差为 9.33 岁，范围为 15-49 岁。关于婚姻状况，7526 名（63.43%）已婚。
冈比亚育龄妇女获得医疗保健服务的问题发生率为 45.5%（95%置信区间：44.6%，46.4%）。年龄（调整后的优势比（AOR）=1.48，95%置信区间：1.12，1.95）、农村居住（AOR=1.28，95%置信区间：1.07，1.53）、产次（AOR=1.07，95%置信区间：1.03，1.12）、中等（AOR=0.54，95%置信区间：0.46，0.64）和更高财富（AOR=0.30，95%置信区间：0.25，0.37）、在医疗机构分娩（AOR=0.69，95%置信区间：0.58，0.80）、目前工作（AOR=0.77，95%置信区间：0.68，0.86）和地理区域与获得医疗保健服务的问题显著相关。
冈比亚育龄妇女获得医疗保健服务的问题较为严重。年龄、区域、工作状况、产次、居住、财富和分娩地点是与获得医疗保健服务问题相关的因素。政策制定者和公共卫生专家在设计孕产妇保健方案时应考虑这些因素。应设计负担得起的医疗保健服务方案，以增加冈比亚的医疗保健服务可及性。
