Association between the Survey-based Women’s Empowerment (SWPER) index and barriers to healthcare in sub-Saharan Africa

Int Health. 2025 May 20:ihaf023. doi: 10.1093/inthealth/ihaf023. Online ahead of print.

ABSTRACT

BACKGROUND: Women’s health is an essential component of the Sustainable Development Goals. We examined how women’s empowerment influences barriers to healthcare access in sub-Saharan Africa.

METHODS: The study included a weighted sample of 188 572 women’s data from the Demographic and Health Surveys of 21 countries. A multilevel binary logistic regression analysis was used to examine the association between women’s empowerment and barriers to accessing healthcare.

RESULTS: Women in the medium and high categories of attitude towards violence, social independence and autonomy were less likely to experience problems in getting permission to go for treatment. Women who had high attitudes towards violence were less likely to experience problems in getting money for treatment. Women with high social independence were less likely to face problems getting money for treatment. Women with high scores for attitudes towards violence, social independence and decision-making had the lowest likelihood of experiencing difficulty with distance to a health facility. Similarly, those in the high categories for attitude towards violence, social independence and decision-making had the lowest odds of experiencing problems not wanting to go alone.

CONCLUSIONS: Women’s empowerment decreases the barriers to accessing healthcare in sub-Saharan Africa. Designing healthcare intervention programs for women should consider the contribution that women make to household decision-making, social independence and attitudes towards violence.

PMID:40390700 | DOI:10.1093/inthealth/ihaf023