The unseen struggle: Intersectionality and healthcare access for women in Nigeria's low-income communities

Anthonia Folasade Ibitoye

Abstract


One of the major challenges for women in low-income Nigerian communities is limited access to healthcare, leading to poor health outcomes and higher mortality rates. This study examines the barriers faced by women in Ekiti State using intersectional feminist theory and a cross-sectional design. Data were collected through structured questionnaires from 300 women aged 18 and above, selected via multistage sampling (stratified, purposive, and simple random). Analysis was conducted with SPSS version 25.0 using descriptive (frequency and percentages) and inferential (multiple regression) statistics. Findings show that all respondents experienced difficulties in accessing healthcare: 86% reported financial constraints, 84.7% cited lack of affordable and quality facilities, and 80% identified distance as a major barrier. Marital status (β = 0.373, p < 0.05), occupation (β = 0.243, p < 0.05), age (β = 0.080, p < 0.05), and education (β = 0.051, p < 0.05) were significant predictors of healthcare access challenges. The study concludes that tailored interventions are essential to address these barriers. To improve access and reduce mortality, it recommends increased healthcare funding, financial protection mechanisms, expanded health education, stronger social support networks, and contextspecific interventions.


Keywords


healthcare access; healthcare disparities; intersectionality; low-income communities; women’s health

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References


Adebayo, C. T., Parcell, E. S., Mkandawire- Valhmu, L., & Olukotun, O. (2024). African American women's maternal healthcare experiences: A critical race theory perspective. In Emergent health communication scholarship from and about African American, Latino/a/x, and American Indian/Alaskan Native peoples (pp. 79–90). Routledge.

Ali, H. A., Hartner, A. M., Echeverria- Londono, S., Roth, J., Li, X., Abbas, K., & Gaythorpe, K. A. (2022). Vaccine equity in low- and middle-income countries: A systematic review and meta-analysis. International Journal for Equity in Health, 21(1), 82–99. https://doi.org/10.1186/s12939-022-01688-1

Chimezie, R. O. (2023). Health awareness: A significant factor in chronic diseases prevention and access to care. Journal of Biosciences and Medicines, 11(2), 64–79. https://doi.org/10.4236/jbm.2023.112007

Chinn, J., Martin, I., & Redmond, N. (2021). Health equity among Black women in the United States. Journal of Women’s Health, 30(2), 212–219. https://doi.org/10.1089/jwh.2020.8882

Cohen, J., & Van Der Meulen Rodgers, Y. (2023). An intersectional analysis of long COVID prevalence. International Journal for Equity in Health, 22(1), 261–278. https://doi.org/10.1186/s12939-023-01998-5

Collins, P. H. (2000). Black feminist thought: Knowledge, consciousness, and the politics of empowerment. Routledge.

Crenshaw, K. (1989). Demarginalizing the intersection of race and sex: A Black feminist critique of antidiscrimination doctrine, feminist theory, and antiracist politics. University of Chicago Legal Forum, 1989(1), 139–167.

Esan, D. T., Sokan-Adeaga, A. A., & Rasaq, N. O. (2022). Assessment of satisfaction with delivery care among mothers in selected health care facilities in Ekiti State, Nigeria. Journal of Public Health Research, 11(4), 22799036221127572. https://doi.org/10.1177/22799036221127572

Federal Ministry of Health. (2017). National health policy. FGN.

Fufaa, G. D. (2024). The role of preventive health care in preventing chronic diseases. [Unpublished manuscript].

Gatla, T. R. (2024). An innovative study exploring revolutionizing healthcare with AI: Personalized medicine, predictive diagnostic techniques, and individualized treatment. International Journal of Advanced Research and Interdisciplinary Scientific Endeavours, 1(2), 61–70.

George, M. S., Davey, R., Mohanty, I., & Upton, P. (2020). “Everything is provided free, but they are still hesitant to access healthcare services”: Why does the indigenous community in Attapadi, Kerala continue to experience poor access to healthcare? International Journal for Equity in Health, 19(1), 105. https://doi.org/10.1186/s12939-020-01216-1

Gilbert, L., Nguyen, J., & Jackson Scroggins, M. (2021). Women’s health equity. In K. Smalley, J. Warren, & M. Fernandez (Eds.), Health equity: A solutions-focused approach. Springer.

Grin, G., Ali, M., Nau, S. Z., Riggs, E., & Dantas, J. A. R. (2022). Accessing and navigating healthcare: A scoping review of the experiences of women of refugee background from Myanmar. Health & Social Care in the Community, 30(6), e3459– e3476. https://doi.org/10.1111/hsc.13955

Hancock, A.-M. (2007). When multiplication doesn't equal quick addition: Examining intersectionality as a research paradigm. Perspectives on Politics, 5(1), 63–79. https://doi.org/10.1017/S1537592707070065

Hartmann, J. M., Mukherjee, T. I., Khadra, M., Kaushal, N., El-Bassel, N., & Dasgupta, A. (2023). Perceived discrimination and poverty among Syrian refugee women in Jordan. Refuge, 39(2), 1–14. https://doi.org/10.25071/1920-7336.40868

Khatri, R. B., & Assefa, Y. (2022). Access to health services among culturally and linguistically diverse populations in the Australian universal health care system: Issues and challenges. BMC Public Health, 22(1), 880. https://doi.org/10.1186/ s12889-022-13107-9

Lara-Morales, A., Soto-Ruiz, N., Agudelo- Suárez, A. A., & García-Vivar, C. (2024). Social determinants of health in post-treatment cancer survivors: Scoping review. European Journal of Oncology

Nursing, 70, 102375. https://doi.org/10.1016/j.ejon.2024.102375

Livingston, V., Jackson-Nevels, B., & Reddy, V. V. (2022). Social, cultural, and economic determinants of well-being. Encyclopedia, 2(3), 1183–1199. https://doi.org/10.3390/encyclopedia2030075

Makhanya, M. T. B. (2024). Between intersectionality and socioeconomic inequality. In Bridging social inequality gaps: Concepts, theories, methods, and tools (p. 51).

Mandalia, K., Ames, A., Parzick, J. C., Ives, K., Ross, G., & Shah, S. (2023). Social determinants of health influence clinical outcomes of patients undergoing rotator cuff repair: A systematic review. Journal of Shoulder and Elbow Surgery, 32(2), 419–434. https://doi.org/10.1016/j.jse.2022.08.021

Matud, M. P., Bethencourt, J. M., Ibáñez, I., Fortes, D., & Díaz, A. (2022). Gender differences in psychological well-being in emerging adulthood. Applied Research in Quality of Life, 17(2), 1001–1017. https://doi.org/10.1007/s11482-020-09914-7

Mohd Rosnu, N. S., Singh, D. K. A., Mat Ludin, A. F., Ishak, W. S., Abd Rahman, M. H., & Shahar, S. (2022). Enablers and barriers of accessing health care services among older adults in South-East Asia: A scoping review. International Journal of Environmental Research and Public Health, 19(12), 7351. https://doi.org/10.3390/ ijerph19127351

Moroz, N., Moroz, I., & D’Angelo, M. S. (2020). Mental health services in Canada: Barriers and cost-effective solutions to increase access. Healthcare Management Forum, 33(6), 282–287. https://doi.org/10.1177/0840470420945622

Mosley, T. J., Zajdel, R. A., Alderete, E., Clayton, J. A., Heidari, S., Pérez- Stable, E. J., ... & Bernard, M. A. (2025). Intersectionality and diversity, equity, and inclusion in the healthcare and scientific workforces. The Lancet Regional Health–Americas, 41, 100456. https://doi.org/10.1016/j.lana.2025.100456

National Bureau of Statistics. (2017). Population projection for Abuja.

O'Halloran, R., Renton, J., Harvey, S., McSween, M. P., & Wallace, S. J. (2024). Do social determinants influence post- stroke aphasia outcomes? A scoping review. Disability and Rehabilitation, 46(7), 1274–1287. https://doi.org/10.1080/09638288.2022.2138472

Okoro, O. N., Hillman, L. A., & Cernasev, A. (2022). Intersectional invisibility experiences of low-income African- American women in healthcare encounters. Ethnicity & Health, 27(6), 1290–1309. https://doi.org/10.1080/13557858.2021.1873255

Olamide, A. E., Jolayemi, E. T., & Atolagbe, J. E. (2025). Determinants of maternal health seeking behavior among pregnant women in some selected primary health care centers in Ado-Ekiti Local Government Area, Ekiti State. [Manuscript in preparation].

Oluwadare, C. T., Aladejare-Salako, A. A., Sunmola, A. K., Ibikunle, M. A., & Ijabadeniyi, O. A. (2024). Socio- economic differentials of antenatal health care utilisation in Ekiti State, Nigeria. International Journal of Research and Innovation in Social Science, 8(1), 1254–1264. https://doi.org/10.47772/ IJRISS.2024.8119

Oluwadare, C. T., Olorunfemi, A. A., & Igbekoyi, K. E. (2023). Social and non- social factors influencing access to healthcare in Ekiti and Kogi States of Nigeria. [Unpublished manuscript].

Oluwadare, C. T., Olorunfemi, A. A., Atiba, A. S., & Ijabadeniyi, O. A. (2021). A comparative assessment of access to healthcare of people living in Ekiti and Kogi States of Nigeria. Asian Journal of Medicine and Health, 19, 7–17. https://doi.org/10.9734/ajmah/2021/v19i430334

Saxena, S., Arsh, A., Ashraf, S., & Gupta,N. (2023). Factors influencing women's access to healthcare services in low- and middle-income countries: A systematic review. Nursearcher, 3(2), 67–75. https://doi.org/10.54393/nrs.v3i02.47

Sugandh, F. N. U., Chandio, M., Raveena, F. N. U., Kumar, L., Karishma, F. N. U., Khuwaja, S., ... & Sugandh, F. (2023). Advances in the management of diabetes mellitus: A focus on personalized medicine. Cureus, 15(8), e43729. https://doi.org/10.7759/cureus.43729

Tebbe, E. A., & Budge, S. L. (2022). Factors that drive mental health disparities and promote well-being in transgender and nonbinary people. Nature Reviews Psychology, 1(12), 694–707. https://doi.org/10.1038/s44159-022-00087-w

Vohra Gupta, S., Petruzzi, L., Jones, C., & Cubbin, C. (2023). An intersectional approach to understanding barriers to healthcare for women. Journal of Community Health, 48, 89–98. https://doi.org/10.1007/s10900-022-01147-8

Wang, E., Glazer, K. B., Sofaer, S., Balbierz, A., & Howell, E. A. (2021). Racial and ethnic disparities in severe maternal morbidity: A qualitative study of women's experiences of peripartum care. Women's Health Issues, 31(1), 75–81. https://doi.org/10.1016/j.whi.2020.09.005

World Health Organization. (2019). Maternal mortality ratio (per 100 000 live births). WHO.

Yong, A., & Germain, S. (2022). Ethnic minority and migrant women’s struggles in accessing healthcare during COVID-19: An intersectional analysis. Journal for Cultural Research, 26(1), 65–82. https://doi.org/10.1080/14797585.2022.20 60856

Zegeye, B., El-Khatib, Z., Ameyaw, E. K., Seidu, A. A., Ahinkorah, B. O., Keetile, M., ... (2021). Breaking barriers to healthcare access: A multilevel analysis of individual- and community-level factors affecting women's access to healthcare services in Benin. International Journal of Environmental Research and Public Health, 18(2), 750. https://doi.org/10.3390/ijerph18020750

Zhang, Y. (2022). Access to healthcare facilities and women's healthcare requirements in urban areas: A case study of Beijing. International Journal of Environmental Research and Public Health, 19(6), 3709. https://doi.org/10.3390/ijerph19063709




DOI: https://doi.org/10.21107/sml.v8i2.30204

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