Barriers to Healthcare Access and its associated factors among Reproductive-Age Women in Somalia: Based On Somalia Demographic and Health Survey 2020 Data: Cross-sectional Study

Background: Access to health care services is a common problem in developing countries including Somalia. SDG 3 advocates for the provision of quality healthcare and the promotion of overall well-being for everyone, regardless of age, underscoring the necessity of addressing health inequalities. Hence, this study aims to assess the magnitude and factors associated with problems to healthcare access in Somalia using insights from SDHS. Methods: This study was a cross-sectional analysis of secondary data from the Somalia Demographic and Health Survey 2020. A sample size of 10,733 reproductive-age women was utilized. Binary logistic regression analysis was performed to identify predictors of healthcare access problems. Results: The prevalence of barriers to healthcare access was 72.60% (95%CI: .717-.734. Women in higher education (AOR: 2.63; 95% CI: 1.79-3.85), widowed women (AOR: 1.28; 95%CI: 1.03-1.58), second wealth quantile (AOR: 1.50; 95%CI: 1.28-1.76), middle quantile (AOR: 2.16; 95%CI: 1.78-2.61) fourth quantile (AOR: 2.74; 95%CI: 2.26-3.33) fifth quantile (AOR: 3.57 95%CI: 2.92-4.37), being a resident in the regions of Togdheer (AOR: .477; 95%CI: .363-.626), Sanaag (AOR: .611; 95%CI: .470-.794), Mudug (AOR: .675; 95%CI: .511-.892), Galgaduud (AOR: .582; 95%CI: .433-.783), Hiraan (AOR: .684; 95%CI .513-.913), Banaadir (AOR: .627; 95%CI: .491-.801), Bay (AOR: .279; 95%CI: .176-.442), Gedo (AOR: 1.47; 95%CI: 1.12-1.93), Lower juba (AOR: 1.80; 95%CI: 1.38-2.33), and having five or more than five children (AOR: .802; 95%: .718-.896) were identified as the predictors of barriers to healthcare access in Somalia. Conclusion: The study identifies significant barriers to Somali women's access to healthcare, which are influenced by variables such as family size, wealth index, marital status, and education. the study encourages focused interventions to lower healthcare inequities by enhancing affordability, raising awareness, and improving infrastructure.