UCLA

Aim: Women are faced with a number of health risks and vulnerabilities particular to their gender which impact their access to healthcare. The aim of this study was to assess variations in satisfaction with access to healthcare for women in Bolivia and throughout eighteen Latin American countries and demographic and contextual level variables associated with differences in satisfaction.

Data and Methods: Data from the Latinobarometro Survey and World Health Organization country indicators for the 2004-2007 periods was obtained for eighteen countries providing a sample of 37,971 women. Multiple linear and non-linear regression models examined the association of satisfaction with access and health condition, income, health insurance, location of home, ethnicity and national levels of healthcare spending per capita.

Results: In multivariate analyses, lower levels of satisfaction with access were associated with lower income, poorer health condition and being uninsured or having public insurance (compared with having private insurance). Women living in rural and peri-urban areas are generally more satisfied with access to care than those living in provincial capitals. When the sample is stratified by health condition, those in poor or fair health are less satisfied, even when they have greater income or are better insured (private) or taking into account the country they live in. Country to country variations in satisfaction with access to healthcare are wider for women whose income is insufficient, women living in the peri-urban areas and those lacking health insurance. Greater national healthcare spending per capita does not guarantee satisfaction for women in the region.

Conclusions: As women continue to be the first educators, caretakers and protectors of children, their role is fundamental to any effective development strategy. The primary focus of health policy in Latin America should be to improve equitable access for women to high quality healthcare. Satisfaction with access to healthcare is a signal of health system performance, and this study finds substantial room for improvement. Health information systems are needed to compile and analyze data on an ongoing basis to better measure women's access to and use of health services to aid decision-making on improving healthcare systems.