Inequalities in Childhood Healthcare Access Among Racial and Ethnic Groups of Sub-Saharan Africa: A Narrative Review

TL;DR

This paper reviews how racial and ethnic disparities affect childhood healthcare access in Sub-Saharan Africa, finding that marginalized groups face significant barriers.

Contribution

The study systematically aggregates evidence on racial/ethnic disparities in childhood healthcare access in Sub-Saharan Africa.

Findings

Ethnicity independently contributes to lower vaccination coverage among groups like Hausa/Fulani and Somali/Luhya.

Child mortality is higher in economically and ethnically marginalized groups.

Stunting and underweight odds are elevated in certain ethnic minorities.

Abstract

Background/Objective: Child health serves as a foundational part of human development. Inequities in access to key health services remain high in Sub-Saharan Africa (SSA), most notably among children from disadvantaged, racially, or ethnically marginalized groups. The objective of this structured narrative review is to evaluate and aggregate the available evidence on racial/ethnic disparities in childhood healthcare access in SSA. Methods: A comprehensive search on African Index Medicus (AIM), Web of Science and PubMed for studies published between 2010 and 2025 was executed using relevant MeSH terms and Boolean operators. Studies on healthcare access inequalities among racial or ethnic groups in SSA were included. This study was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: Ten articles were included. Ethnicity was an independent contributor to inequities in childhood healthcare across four domains: vaccination coverage (lower for Hausa/Fulani in Nigeria and Somali/Luhya in Kenya compared to dominant groups), timeliness of vaccination, child mortality (higher in economically and ethnically marginalized groups), and nutritional status (elevated stunting and underweight odds in certain ethnic minorities). Conclusions: Racial and ethnic inequalities in child healthcare access across SSA are driven by multi-factor structural, geographical, and cultural barriers. Although socioeconomic improvement reduces some disparities, it does not eradicate them, highlighting that ethnic identity continues to shape health outcomes independently. Addressing these disparities requires strengthening culturally inclusive healthcare delivery, improving access in underserved regions, and integrating ethnicity-disaggregated monitoring into national health systems.

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