{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T08:34:55Z","timestamp":1793349295584,"version":"4.5.0"},"reference-count":57,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2025,1,16]],"date-time":"2025-01-16T00:00:00Z","timestamp":1736985600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Access to healthcare services for women in low- and middle-income countries (LMICs) is crucial for maternal and child health and achieving the Sustainable Development Goals (SDGs). However, women in LMICs face barriers to accessing healthcare, leading to poor health outcomes. This study used Demographic and Health Survey (DHS) data from 61 LMICs between 2010\u20132023 to identify women\u2019s healthcare access challenges.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study used data from the DHS conducted in 61 LMICs to identify women\u2019s healthcare access challenges from 2010 to 2023. A weighted sample of 1,722,473 women was included in the study using R-4.4.0 version software. A mixed-effects modeling approach was used to analyze access to healthcare, considering individual-level factors and contextual factors. The mixed-effects model takes into account clustering within countries and allows for the examination of fixed and random effects that influence women\u2019s healthcare access across LMICs. For the multivariable analysis, variables with a p-value \u22640.2 in the bivariate analysis were considered. The Adjusted Odds Ratio (AOR) with a 95% Confidence Interval (CI) and a P value &lt; 0.05 was reported to indicate statistical significance and the degree of association in the final model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The pooled prevalence of the healthcare access problem was found to be 66.06 (95% CI: 61.86, 70.00) with highly heterogeneity across countries and regions. Women aged 25\u201334 years, and 35\u201349 years, had primary education, and secondary or higher education, married women, poorer, middle, richer, and richest wealth indices, had mass media exposure, first birth at age \u226520 years, birth interval of 24\u201336, 37\u201359 and &gt;59 months as compared to &lt; 24 months birth interval, had health insurance, delivered at a health facility, had at least one ANC visit, being from lower-middle-income countries, upper-middle-income countries, regions like West Africa, South Asia, and East Asia\/Pacific compared to women living in East Africa, low literacy rates, medium literacy rates, and high literacy rates as compared to very low literacy rate were associated with lower odds of having problems accessing healthcare respectively. On the other hand, divorced\/widowed women, having 1\u20132, and more than two under five, living in households with 6\u201310 family members and &gt;10 members, female household heads, living in rural areas, women living in South\/Central Africa, Middle East\/North Africa, Europe\/Central Asia, and living in Latin America\/Caribbean were associated with higher odds of having problems accessing healthcare respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Approximately two-thirds of women face healthcare access problems. Sociodemographic factors such as age, education, marital status, wealth, media exposure, and health insurance are associated with lower odds of experiencing healthcare access issues. On the other hand, factors such as divorce\/widowhood, the number of young children, household size, female household heads, rural residence, and region have been linked to higher odds of facing healthcare access challenges. To address these disparities, policies, and interventions should focus on vulnerable populations by improving access to health insurance, increasing educational attainment, and providing support for single mothers and large households. Additionally, tailored regional approaches may be necessary to overcome barriers to healthcare access.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0314309","type":"journal-article","created":{"date-parts":[[2025,1,16]],"date-time":"2025-01-16T13:37:33Z","timestamp":1737034653000},"page":"e0314309","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":43,"title":["Uncovering women\u2019s healthcare access challenges in low- and middle-income countries using mixed effects modelling approach: Insights for achieving the Sustainable Development Goals"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0063-0999","authenticated-orcid":true,"given":"Bewuketu","family":"Terefe","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Belayneh Shetie","family":"Workneh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gebreeyesus Abera","family":"Zeleke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enyew Getaneh","family":"Mekonen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alebachew Ferede","family":"Zegeye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agazhe","family":"Aemro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berhan","family":"Tekeba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0760-1100","authenticated-orcid":true,"given":"Tadesse Tarik","family":"Tamir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mulugeta","family":"Wassie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed Seid","family":"Ali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,1,16]]},"reference":[{"key":"pone.0314309.ref001","article-title":"Progress of the world\u2019s women 2015\u20132016: Transforming economies, realizing rights","author":"U. 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