Comparison of the Number and Reasons for Self-Perceived Barriers to Accessing Primary Health Care Services Between Roma and Ethnic Albanians

Abstract Introduction To compare the number and reasons for self-perceived barriers to accessing primary health care (PHC) services between Roma/Egyptian and ethnic Albanians. Methods 533 adults (mean age: 45±18 years; ≈60% women) reporting barriers to accessing PHC services were recruited consecutively during a nationwide survey in October 2024 across all four regions of Albania, using probability-proportional-to-size sampling. A semi-structured questionnaire was administered by trained interviewers inquiring about the number and reasons for self-perceived barriers to accessing PHC services, health characteristics, and sociodemographic factors. General linear models and binary logistic regression were employed to assess the association between perceived barriers and ethnic groups. Results 444 (≈83%) participants were ethnic Albanians, whereas the remaining 89 (≈17%) individuals belonged to other ethnic groups, including Roma (n = 57), Egyptians (n = 30), and Gorani or Macedonians (n = 2). Overall, cost and waiting time were the most common barriers. Roma/Egyptian minorities faced more cultural and language issues, whereas Albanians reported higher distrust and service-related expectations. The crude mean number of barriers to accessing PHC services was higher among Roma/Egyptian minorities than among Albanians (1.8 vs. 1.6, respectively; P = 0.04). The multivariable-adjusted odds of reporting ≥ 2 barriers to accessing PHC services were 93% higher among Roma/Egyptian minorities than in Albanians (P = 0.03). Conclusions Roma/Egyptian minorities experience more barriers in accessing PHC services than ethnic Albanians. However, the cost of services constitutes the main barrier across both groups. Conversely, communication-related barriers affect mainly Roma/Egyptian minorities, whereas Albanians perceive more systemic barriers. In Albania, there is a need for targeted, equity-focused interventions.

• Publication year

  2026

• Venue

  Slovenian Journal of Public Health

• Publication date

  2026-03-01

• Fields of study

  Sociology, Medicine

• Identifiers
  DOI 10.2478/sjph-2026-0002PMID 41783760PMCID PMC12955844
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar

• No claims are published for this paper.

• No concepts are published for this paper.

• Association Between Trust in Health Care Professionals and Health Care Access: Insights From an Online Survey Across 21 Countries

  2025cited by this paper
• Transportation barriers to healthcare access: a scoping review of measurement approaches and associated health outcomes

  2025cited by this paper
• Barriers to primary health care: perspectives of marginalized Roma women and healthcare professionals

  2025cited by this paper
• Systematic meta-review on migrant healthcare access: Language barriers and the role of translation

  2025cited by this paper
• Health Care and Access to Quality Social-Health Services of the Roma and Sinti: A Scoping Review

  2025influential reference
• Prevalence and Sociodemographic Correlates of Nutritional Habits among Schoolchildren Aged 11–15 Years in Albania

  2025cited by this paper
• Ability to Maintain and Improve Health and Socio-Demographic Correlates among Children in Albania

  2024cited by this paper
• Access to healthcare services among vulnerable groups in Albania: unveiling barriers and proposing solutions

  2024influential reference
• Immunization agenda 2030: A global strategy to leave no one behind.

  2024cited by this paper
• Unmet healthcare needs in Southeastern Europe: a systematic review

  2024cited by this paper
• Socio-Demographic Correlates of Barriers to Access Healthcare Services among Children in Post-Communist Albania

  2023cited by this paper
• Mental health and access to care among the Roma population in Europe: A scoping review

  2023influential reference
• Ethnic inequalities in patient satisfaction with primary health care in England: Evidence from recent General Practitioner Patient Surveys (GPPS).

  2022cited by this paper
• Low prevalence of spectacle use in the Hungarian Roma population indicates unmet health needs

  2022cited by this paper
• Health system responsiveness: a systematic evidence mapping review of the global literature

  2021influential reference
• The Role of Perceived Unjust Treatment in Unmet Needs for Primary Care Among Finnish Roma Adults

  2020cited by this paper
• Factors associated with the utilisation of primary care services: a cross-sectional study in public and private facilities in Albania

  2020cited by this paper
• Perspectives of Public and Private Primary Healthcare Users in Two Regions of Albania on Non-Clinical Quality of Care

  2020cited by this paper
• Gypsy, Roma and Traveller access to and engagement with health services: a systematic review

  2018cited by this paper
• Can people afford to pay for health care? New evidence on financial protection in Austria

  2018cited by this paper
• An examination of unmet health needs as perceived by Roma in Central and Eastern Europe.

  2016influential reference
• The mediating effect of discrimination, social support and hopelessness on self-rated health of Roma adolescents in Slovakia

  2015cited by this paper
• Health system characteristics and unmet care needs in Europe: an analysis based on EU-SILC data

  2015cited by this paper
• Applied Logistic Regression

  2002cited by this paper
• Best subsets logistic regression

  1989cited by this paper
• THE WORLD HEALTH ORGANIZATION

  1954cited by this paper

• No citing papers are available for this paper.