Limited Healthcare Access-Annotated Bibliography Sample

Health outcomes in developing countries relies on adequate access to and utilization of the available services. That access and positive health-seeking behavior are amongst other reasons, dependent on the public being adequately informed. The knowledge of healthcare services, availability of professionals, insurance services and basic appreciation of specific disease processes requiring caregiver intervention are critical to ensuring patients end up at the hospital for proper management (Hamiduzzaman et al., 2017).

Additionally, it is essential for crafting equitable healthcare resource allocation. Ngugi et al. (2017) effectively explore that prospect and its implications in healthcare services in rural Kenya, through assessing the prevalence of and determining the factors affecting the utilization of healthcare services. That is especially important as the country’s healthcare reels from an underutilized universal healthcare coverage (UHC), despite the healthcare frontier being devolved to the counties for ease and closeness of service provision.

Ngugi et al. performed a cross-sectional survey in the coastal area of Kenya using the WHO cluster sample design and execute multiple analyses that fed to the parameters assessed. Their findings reveal that up to 23.3% of household members do not seek healthcare services when ill, for various reasons which include self-medication with OTC drugs in 42.8% of them, unaffordability of services to 20% of them and the health facility being too distant to 8.1% of them (Ngugi et al., 2017). Most of the facilities visited were public health facilities nearest to the people’s homes, and comprised of level 2 facilities (dispensaries).

That underscored the role of primary health care in ensuring healthcare access across board. Importantly, it is fronted that poverty impacted the access to healthcare, as people shunned hospital related costs of drugs, transport and overall care for OTC medication, especially where the illness was thought not to be severe (Ngugi et al., 2017). Thus the need for healthcare subsidization and education on public insurance schemes. Whilst family dynamics and power structure came out as an influence in healthcare access, sociocultural issues were not canvassed in this particular study.

In the USA, disparities in healthcare access are as rife, especially among the vulnerable populace and rural communities. That persists despite the rapid evolution of healthcare, and is attributable, largely, to socioeconomic reasons. Therefore, the growing calls to modify care provision to cater for every citizen are only getting louder.

Some of the positives from the advocacy have been the enactment of the Affordable Care Act 2010 and the continual refinement of the Medicare and Medicaid policies to cater for affordability of care (Hamiduzzaman et al., 2017). Bhatt et al. (2018) explain the improvement of healthcare access mechanisms such as advancing care, the creation of novel model for stakeholder collaboration as well as improving commitment in healthcare access, partners, value and coordination.

Bhatt et al. underscore the tenets of the American Hospital Association, which seeks to improve quality, access, and integrated care. Healthcare access is even more vital since 25% of American have multiple chronic comorbidities which occasion the need for continuous care and increased healthcare expenditure (George et al., 2018). Consequently, they advocate for economic strategization of vulnerable communities through healthcare reforms that avail essential and specialized services at affordable value for them.

These vulnerable group comprise of an unhealthy mix of poor, uninsured, illiterate and unemployed people, who also deserve to benefit from the healthcare reform package in a simple, yet robust manner. To enhance healthcare access, Bhatt et al. (2018) proposes the ‘collecting of race, ethnicity, language preference, and other sociodemographic data and using those data to stratify quality metrics, as well as increasing cultural competency training for all clinicians and employees and increasing diversity in health care leadership and governance.’

The model is centred on strategies which include tackling the social health determinants, adopting novel virtual care modalities, and employing inpatient/outpatient transformation strategy (George et al., 2018). Overall, improving access to healthcare is thus corrected from a sociocultural, hospital, facility and federal level hence better outcomes.

Latinos constitute one of the minority groups in the USA, mostly habiting rural states and indulging in large-scale farming. Akin to other minority groups, access to healthcare, although steadily improving, has been low. Tulimiero et al. (2021) describe the reasons for this as limited hospital numbers and transport in the rural areas, language barriers with the existing caregivers, lack of insurance, financial challenges, as well as entrenched sociocultural practices that often preclude health-seeking behavior. Some of them are undocumented immigrants as well, hence have a lingering fear of deportation.

They demonstrate the role and acceptability of mobile clinic units in bridging primary care provision among the rural Latino community. That is because the clinics were accessible, convenient, and had short waiting times (Tulimiero et al., 2021). Consequently, the Latinos demonstrate structural vulnerability, which is not being receptive to the traditional healthcare models that centered on brick and motor effigies with specific clinic hours and appointment schedules. Tulimiero et al. (2021), therefore, suggest the innovation of healthcare provision strategies especially for such communities, if positive health-seeking behavior is to be encouraged.


  • Bhatt, J., & Bathija, P. (2018). Ensuring access to quality health care in vulnerable communities. Academic medicine93(9), 1271. doi: 10.1097/ACM.0000000000002254
  • George, S., Daniels, K., & Fioratou, E. (2018). A qualitative study into the perceived barriers of accessing healthcare among a vulnerable population involved with a community centre in Romania. International journal for equity in health17(1), 1-13.
  • Hamiduzzaman, M., De Bellis, A., Abigail, W., & Kalaitzidis, E. (2017). The social determinants of healthcare access for rural elderly women-a systematic review of quantitative studies. The Open Public Health Journal10(1).
  • Ngugi, A. K., Agoi, F., Mahoney, M. R., Lakhani, A., Mang’ong’o, D., Nderitu, E., … & Macfarlane, S. (2017). Utilization of health services in a resource-limited rural area in Kenya: prevalence and associated household-level factors. PloS one12(2), e0172728.
  • Tulimiero, M., Garcia, M., Rodriguez, M., & Cheney, A. M. (2021). Overcoming barriers to health care access in rural Latino communities: an innovative model in the eastern Coachella Valley. The Journal of Rural Health37(3), 635-644.