Determinants of barriers to healthcare services utilization among women in Tanzania: findings from the 2022 Tanzania Demographic and Health Survey

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.