OBJECTIVES: Ethiopia has been working to reform the national health care financing system since 2008 and instituted solidarity-based health insurance schemes in the early years of the past decade. However, little is known about the effects of the health sector reforms with respect to access to health care. This study aimed to identify the influence of socio-economic status indicators and health insurance coverage on access to health care services among women in Ethiopia.

METHODS: The study employed secondary data analysis of the 2016 Ethiopian demographic and health survey (DHS) dataset for women aged between 15 and 49 years old. The analysis involved a total of 15683 women. Univariate and multivariate logistic regression analysis, Odds ratios (OR) and 95% confidence intervals (CI) were calculated for the relevant variables. All p-values less than 0.05 were considered statistically significant.

RESULTS: More than half (10084; 64.3%) of the respondents reported facing at least one barrier to access health care services meaning only 36.7% of the women had easy access to health services. Being married/living together (OR = 1.339; 95% CI = 1.204-1.489), having some form of formal education (OR = 1.194; 95% CI = 1.088-1.310), and being in the richest quintile in terms of wealth status (OR = 3.647; 95% CI = 3.132-4.247) were independent predictors of better access to health care services. In contrast, being older than 19 years of age (OR = 0.841; 95% CI = 0.753-0.940) and living in rural areas (OR = 0.7; 95% CI = 0.613-0.8) independently predicted lesser access to health care. Moreover, women who had insurance coverage were about 1.6 times (95%CI = 1.336-1.880, p<0.001) more likely to have access to health care than their uninsured counterparts.

CONCLUSIONS: Based on these findings, targeting of vulnerable individuals in health policy implementation and expansion of health insurance are recommended.