Copyright (c) 2026 Jorge Alirio Holguín-Ruiz , Mercedes Salcedo-Cifuentes, Paula Bermúdez , Constanza Diaz Grajales, Nicolas Ortiz Ruiz, Salomé Víctoria
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Rural healthcare access in 12 municipalities of Valle del Cauca prioritized based on TB notification and vulnerability conditions
Introduction. Rural populations in Latin America face barriers to accessing health services, increasing their vulnerability to preventable diseases such as tuberculosis. This study aimed to identify sociodemographic and structural factors associated with perceived barriers to healthcare access among rural residents in 12 municipalities of Valle del Cauca prioritized for TB notification and vulnerability conditions. Methods. Analytical cross-sectional study (August–December 2022) in 12 municipalities of Valle del Cauca, prioritized by rurality, poverty, and TB notification. We included 457 adults (≥18 years) enrolled in the subsidized health insurance scheme, selected through stratified random sampling from rural enrollee lists and surveyed using a structured questionnaire. The outcome was perceived difficulty accessing health services when needed in the past 12 months. Descriptive, bivariate, and logistic regression analyses were conducted. Results. Ninety-eight percent of participants reported being insured; over 80% had income at or below the minimum wage, and 47.5% reported difficulties accessing services. The strongest barrier was the need to use multiple modes of transport (OR=4.15; 95% CI: 2.62–6.59), with a trend for poorer self-rated health (OR=1.56; 95% CI: 0.99–2.45). Conclusion. Near-universal insurance coverage does not ensure access to health services in rural areas; mobility and transportation are the main barriers. Differential interventions focused on transport and territorial service coordination are needed.
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