Access to health care problem and associated factors among reproductive age women in Gambia: Using Gambia Demographic Health Survey 2019/20

Abstract Introduction: The risk of maternal death can be reduced through by ensuring that women have access to high-quality care before, during and after childbirth but access to health care problem is still a big public health issueObjective: To assess problems of accessing health care and its associated factors among reproductive age women in GambiaMethods: This study was based on a large community-based cross-sectional survey, conducted from 21 November 2019 to 30 March 2020 in Gambia.The survey employed a stratified two-stage cluster samplingtechnique to recruit study participants. Descriptive statistics and logistic regression models were used to summarize descriptive data and identify factors associated with problems of accessing health care respectively. A p-value of less than 0.05 and 95% confidence interval were used to determine statistical significance.Results: The magnitude of big problem in accessing health care among reproductive age women in Gambia was 45.5%% (95%CI: 44.6, 46.4. Age (AOR=1.48 (95%CI: 1.12,1.95), being from rural residence (AOR=1.28 (95%CI: 1.07,1.53), parity (AOR= 1.07 (95%CI: 1.03,1.12),middle (AOR=0.54(95%CI:0.46, 0.64) and rich wealth (AOR=0.30 (95%CI:0.25, 0.37),give birth at health institution( AOR=0.69 (95%CI: 0.58, 0.80), currently working (AOR=0.77 (95%CI:0.68, 0.86) and geographic region was significantly associated with problems of accessing health care.Conclusion: Problems of accessing health care was high in Gambia. Age, region, working status, parity, residence, wealth and place of delivery were the identified factors associated with problems of accessing health care. Policy makers and public health experts should consider those factors while designing maternal health care program. User friendly, culturally acceptable and affordable health care service program should be designed to increase health care access in Gambia.