Abstract
Introduction
Globally, half of the population is not able to access potential healthcare services, according to the World Bank and World Health Organization (WHO). Specifically, more than 1.5 million women worldwide lack access to healthcare screening. Health inequalities for women lead to excess mortality at all stages of life. Women’s health is still a global public concern and should receive considerable attention, as the health and wealth of any nation rely on its health and wealth. Therefore, this study aims to identify the problems in accessing general health care and the associated factors among women aged 15-49 years in Cambodia.
Methods
This study used existing data from the 2021–2022 Cambodia Demographic and Health Survey and included 19,496 reproductive-aged women aged 15–49 years. We used descriptive statistics like the means and standard deviations to describe continuous variables and calculated weighted frequencies and percentages to report categorical variables. Multivariate logistic regression was employed to assess the strength and magnitude of the associations between factors and problems accessing health care services and to control for confounding factors. Weighted analysis was applied in this study.
Results
The proportion of having at least one of four problems accessing general health care among women aged 15-49 years was 60%. The following factors were found to be statistically significantly associated with health care access problems: no education (AOR=2.23, 95% CI: 1.74--2.85), primary school (AOR=1.82, 95% CI: 1.49--2.22), secondary school (AOR=1.60, 95% CI: 1.34--1.91), living in a rural area (AOR=1.22, 95% CI: 1.08--1.38), having the poorest wealth status (AOR=3.32, 95% CI: 2.72--4.06), having a poorer wealth status (AOR=2.15, 95% CI: 1.80--2.56), having a middle wealth status (AOR=1.88, 95% CI: 1.59--2.21), having a richer wealth status (AOR=1.61, 95% CI: 1.37--1.89), having a greater distance from health care facilities of more than 2 hours (AOR=3.73, 95% CI: 1.31--10.56), having a middle wealth status However, women aged 25--34 years (AOR=0.79, 95% CI: 0.69--0.89), women aged 35--49 years (AOR=0.78, 95% CI: 0.68--0.90), and married women or those reporting living together with their partner (AOR= 0.83, 95% CI: 0.69--0.99) were found to have significantly fewer problems with general health care access.
Conclusion
The study reported that Cambodian women still faced a high proportion of problems accessing general health care. Various factors contributing to these problems, including being a younger woman, not being married, having a lower education level, living in rural areas, having a lower wealth index, and having a longer distance from health care facilities, were found to be the main predictors of health care access problems. The findings of this study are very important for suggesting and recommending that health policymakers, civil society organizations, and other stakeholders pay attention to and strengthen healthcare services for women living in rural areas and far from healthcare facilities and those from low socioeconomic groups.