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Table 4 Barriers to Health Care Utilization among Adolescents in last 12 months across Sites by Gender

From: A mixed methods study to examine the influence of the neighborhood social context on adolescent health service utilization

 

Baltimore

Female W % (U %, N)

Male W % (U %, N)

New Delhi

Female W % (U %, N)

Male W % (U %, N)

Ibadan

Female W % (U %, N)

Male W % (U %, N)

Johannesburg

Female W % (U %, N)

Male W % (U %, N)

Shanghai

Female W % (U %, N)

Male W % (U %, N)

Female (n)

Male (n)

188

248

125

148

219

214

224

271

79

50

Needed but did not seek health care in the last 12 months***

23.4 (23.4, 44)

23.4 (25, 62)

17.3 (18.4, 23)

22.2 (25.0, 37)

9.9 (11.0, 24)**

18.6 (22.0, 47)**

31.6 (33.5, 75)

37.8 (35.8, 97)

20.1 (22.8, 18)

23.7 (22, 11)

Reasons for Not Seeking Care in the last 12 months (among those who needed but did not seek health care)

Female (n)

Male (n)

43

62

23

37

29

47

74

97

18

11

Location

16.5 (11.6, 5)**

5.4 (11.3, 7)**

31.0 (34.8, 8)

47.9 (35.1, 13)

1.9 (3.5, 1)

9.4 (12.8, 6)

12.1 (10.8, 8)

12.2 (14.4, 14)

5.5 (11.1, 2)*

0 (0, 0)*

Distance

12.1 (11.6, 5)

17.1 (11.3, 7)

27.9 (21.7, 5)

16.2 (13.5, 5)

7.8 (6.9, 3)

0 (0, 0)

14.6 (9.5, 7)

10.8 (9.3, 9)

22.8 (33.3, 6)

0 (0, 0)

Fees/payment

11.5 (14.0, 6)

6.5 (8.1, 5)

14.1 (30.4, 7)

13.1 (16.2, 6)

14.6 (13.8, 4)

12.7 (14.9, 7)

10.2 (13.5, 10)

10.3 (13.4, 13)

37.7 (27.8, 5)

7.7 (18.2, 2)

Service hours

5.1 (2.3, 1)

5.3 (6.5, 4)

13.2 (13.0, 3)

4.0 (2.7, 1)

0 (0, 0)

11.3 (8.5, 4)

9.6 (8.1, 6)***

4.2 (7.2, 7)***

9.0 (16.7, 3)

11.1 (18.2, 2)

Waiting time

22.0 (16.3, 7)*

12.6 (12.9, 8)*

25.2 (30.4, 7)

10.7 (8.1, 3)

10.5 (6.9, 2)

19.3 (12.8, 6)

16.3 (20.3, 15)*

11.4 (15.5, 15)*

40.9 (27.8, 5)

35.8 (36.4, 4)

Staff attitude

9.5 (4.7, 2)

0.9 (1.6, 1)

8.3 (8.7, 2)

0 (0, 0)

0 (0, 0)

5.1 (4.3, 2)

9.9 (13.5, 10)

5.9 (10.3, 10)

22.0 (5.6, 1)

27.3 (18.2, 2)

Lack of confidentiality

0.6 (2.3, 1)*

1.9 (1.6, 1)*

7.5 (4.4, 1)

1.0 (2.7, 1)

1.8 (3.5, 1)

1.2 (2.13, 1)

19.3 (13.5, 19)**

6.9 (10.3, 10)**

3.5 (5.6, 1)

13.1 (18.2, 2)

Health problems were connected to illegal activities

3.0 (2.3, 1)*

1.2 (3.2, 2)*

16.4 (21.7, 5)**

3.8 (5.4, 2)**

5.8 (10.3, 3)

18.1 (12.8, 6)

14.6 (5.4, 4)**

2.7 (2.1, 2)**

0 (0, 0)

18.1 (9.1, 1)

Other

33.4 (44.2, 19)

46.8 (45.2, 28)

26.4 (17.4, 4)

35.9 (37.8, 14)

17.8 (20.7, 6)

20.4 (27.7, 13)

9.9 (14.9, 11)

16.3 (22.7, 22)

66.6 (50.0, 9)

45.9 (36.4, 4)

  1. *p < .05; **p < .01;***p < .001