Direct and Indirect cost of access to health facilities among women of reproductive age in Pakistan. Geographic and financial barriers remained significant contributor in seeking care. Results from Pakistan demographic health survey 2012-13

Background: Failure to access health facilities can be attributed to high maternal and child mortality rates in many South Asian countries. However, the socio demographics of the burden of geographical, cultural, and... [ view full abstract ]

Background: Failure to access health facilities can be attributed to high maternal and child mortality rates in many South Asian countries. However, the socio demographics of the burden of geographical, cultural, and financial barriers and its association in seeking care remain unclear. We measured the prevalence of direct and indirect costs of seeking care among women of reproductive age group in Pakistan.
Methods: For this analysis, we used data of 7445 ever married women of age 19 to 45 years from the PDHS 2012–13. Univariate and Multivariate logistic regression analyses were conducted. Results were reported as Odds Ratio with 95 % confidence intervals.
Results: Geographic distance and transportation problems prevented more than 70% of the women from seeking healthcare. Financial burden prevented about 80% women from seeking healthcare. About 70% women were not permitted to access healthcare because either they were not allowed to go alone or they were not permitted. After multivariate adjustments, geographic barriers (OR= 0.11 95 % CI, 0.08–0.42) and financial barriers (OR= 0.72 95 % CI, 0.56–0.92) showed an inverse association with the use of health services among women. Uneducated women (OR= 0.14 95 % CI, 0.10–0.20), who belonged to poor socio-economic status (OR=0.38, 95 % CI, 0.30–0.48), who were married at a young age (OR; 0.82 95 % CI, 0.69-0.98), were less likely to access healthcare. Urban women indicated a strong association (OR=1.84, 95 % CI, 1.51–2.24) of seeking care as compared to rural women.
Conclusion: Geographic location and transportation remained significant problems in seeking healthcare for women. Communities in Pakistan are still facing various barriers to access and utilize healthcare services, especially geographical and financial barriers.
Key words: Geographic location, financial burden, Access to Healthcare, Women, Urban, Rural