International Union for the Scientific Study of Population

Abstract Background: Despite progress in service coverage, many women in Tanzania still face barriers to using healthcare. This study aimed to assess the factors associated with barriers to healthcare utilization among women aged 15-49 years in Tanzania. Methods: We conducted a cross-sectional study using the 2022 Tanzania Demographic and Health Survey. The study included 15,254 women aged 15–49 years. Regional variations in the proportion of respondents with healthcare access were visualized using a spatial map. A multivariable binary logistic regression analysis was conducted. The results were presented as adjusted odds ratios (aORs) with 95% confidence intervals (CIs). All data cleaning and analyses were done using STATA 14 software. Results: In Tanzania, 49.8% [47.9, 51.6] of women reported barriers to healthcare utilization. Women with four or more children had higher odds of facing barriers [aOR = 1.278; 95% CI: 1.06, 1.55] compared to those with no children. Lower odds were observed among women with secondary [aOR = 0.790; 95% CI: 0.67, 0.93] and higher education [aOR = 0.409; 95% CI: 0.25, 0.68], married women [aOR = 0.833; 95% CI: 0.70, 0.99], and those covered by health insurance [aOR = 0.547; 95% CI: 0.43, 0.70]. Women who read newspapers or magazines [aOR = 0.791; 95% CI: 0.71, 0.88] and used the internet [aOR = 0.744; 95% CI: 0.61, 0.91] were also less likely to report barriers to healthcare services utilization, whereas listening to radio was associated with increased odds [aOR = 1.158; 95% CI: 1.03, 1.30]. Socioeconomic inequalities were evident, as women in the poorer [aOR = 0.733; 95% CI: 0.62, 0.87], middle [aOR = 0.513; 95% CI: 0.42, 0.62], richer [aOR = 0.363; 95% CI: 0.29, 0.45], and richest [aOR = 0.238; 95% CI: 0.18, 0.31] quintiles were less likely to experience barriers to healthcare services utilization compared to the poorest. Regional disparities were marked, with women in Northern [aOR = 2.554; 95% CI: 1.88, 3.46], Central [aOR = 2.643; 95% CI: 1.97, 3.55], Lake [aOR = 2.212; 95% CI: 1.73, 2.83], Eastern [aOR = 1.502; 95% CI: 1.10, 2.05], and Zanzibar [aOR = 1.738; 95% CI: 1.32, 2.29] zones having significantly higher odds of reporting barriers to healthcare services utilization compared to those in the Western zone. Conclusion: A substantial proportion of women in Tanzania experience barriers to healthcare utilization. Higher parity, lower educational attainment, lack of health insurance, limited exposure to media, lower wealth index, marital status, and geographical region were factors identified to be associated with problems in accessing healthcare in Tanzania. Policymakers should prioritize reducing regional disparities, improving geographic and financial access, expanding health insurance, strengthening community-based services, and promoting health education and digital literacy to advance equity in healthcare utilization.

Abstract Despite the fact that international migrants comprise 3.1 percent of the world population, international migration is at the heart of societal, economic and political debates. This may be attributed, in part, to the fact that the estimated 214 million international migrants are not evenly distributed among countries and regions. Citizens in some countries comprise a minority compared to expatriates. The case of the Arab Gulf countries is a classical model of this demographic imbalance. Moreover, while females comprise 49 percent of international migrants, sex composition of international migrants is imbalanced among countries and regions.Because of the economic nature of migration, keeping aside forced migration, some members of families leave their origin for better-paid jobs in destination countries. This phenomenon contributes to family breakdown between origin and destination. Family breakdowns are associated with an array of socio-economic correlates and result from major problems related to child rearing and female-headed households, in the case of household head migration. Acknowledging the important positive economic impact of migration, negative socio-economic impacts of migration should be considered and explored, and policy interventions at the micro and macro levels should be introduced.