BEYOND REACH: UNCOVERING BARRIERS TO HEALTHCARE ACCESS AMONG THE MARGINALIZED POPULATION OF PAKISTAN

Abstract

This study explored the complex socio-cultural, economic, and institutional barriers that restricted healthcare access for marginalized rural women—particularly pregnant and lactating women—in the districts of Mardan and Swabi, Khyber Pakhtunkhwa, Pakistan. A qualitative research design was adopted, and purposive sampling was used to conduct in-depth interviews, focus group discussions, and key informant interviews with rural women, healthcare providers, and NGO representatives. Data were analyzed thematically using NVivo software, which revealed three overarching categories of barriers: socio-cultural constraints such as patriarchal norms, mobility restrictions, and traditional beliefs; economic hardships including hidden healthcare costs and the prioritization of household needs over maternal care; and institutional challenges such as staff shortages, absenteeism, and poor infrastructure in public health facilities. The findings demonstrated how intersecting layers of gender, poverty, and geographic isolation created a cycle of neglect and delay in accessing maternal healthcare services. The study recommended culturally sensitive community engagement, financial support mechanisms, improved transport infrastructure, recruitment of female health workers, and community-level accountability systems to enhance equitable access. These multi-faceted interventions were deemed essential for dismantling systemic exclusions and promoting maternal health equity in rural Pakistan.