Barriers to women’s access to healthcare in Sudan: insights into male influence and structural constraints

Abstract

BACKGROUND: Women in Sudan face significant challenges in access to healthcare due to financial hardship, male decision-making influence and geographic limitations, contributing to delayed care-seeking barriers to maternal and reproductive healthcare, and persistent health inequities. METHODOLOGY: A community-based cross-sectional study was conducted among 760 Sudanese women aged 18 years and above using a structured interviewer-administered questionnaire. Data were collected through face-to-face interviews across urban and rural areas, and associations with healthcare accessibility were examined using binary logistic regression analysis. RESULTS: Financial limitations were a major barrier, with 24.8% of women reporting rare or no financial ability to access healthcare. Additionally, 32.1% always required male permission to seek care and 7.6% experienced healthcare delays due to male family members' decisions. Women living more than 10 km from a healthcare facility were 7.1 times more likely to report inadequate access. Nearly half of the participants 49.6% strongly disagreed that male family members understood the importance of timely healthcare. CONCLUSION: Women's access to healthcare in Sudan remains constrained by interconnected economic, sociocultural, and geographic barriers. The findings highlight that urgent policy reforms are needed to expand affordable and geographically accessible healthcare services, strengthen women's financial and decision-making autonomy, and promote community-based interventions that engage men in supportive healthcare practices. CLINICAL TRIAL NUMBER: Not applicable.