Socio-demographic factors related to children's knowledge about their rights to healthcare services in transitional Albania

Our aim was to assess the level and socio-demographic correlates of knowledge about rights to healthcare services among children in post-communist Albania in order to inform targeted interventions and policies to promote equitable healthcare access for all children. An online survey conducted in Albania in September 2022 included a nationwide representative sample of 7,831 schoolchildren (≈54% girls) aged 12-15 years. A structured and anonymous questionnaire was administered inquiring about children's knowledge on their rights to healthcare services. Binary logistic regression was used to assess the association of children's knowledge about their rights to healthcare services with socio-demographic characteristics. Overall, about 78% of the children had knowledge about their rights to healthcare services. In multivariable adjusted logistic regression models, independent "predictors" of lack of knowledge about rights to healthcare services included male gender (OR = 1.2, 95% CI = 1.1-1.3), younger age (OR = 1.3, 95% CI = 1.1-1.4), pertinence to Roma/Egyptian community (OR = 1.6, 95% CI = 1.1-2.2), and a poor/very poor economic situation (OR = 1.3, 95% CI = 1.0-1.6). Our findings indicate a significantly lower level of knowledge about rights to healthcare services among children from low socioeconomic families and especially those pertinent to ethnic minorities such as Roma/Egyptian communities, which can result in limited access to essential health services, increased vulnerability to health disparities, and barriers to receiving appropriate care and advocacy for their health and well-being. Seemingly, gender, ethnicity, and economic status are crucial for children's knowledge of their healthcare rights because these factors shape their access to information, influence their experiences with healthcare systems, and can drive policy and practice to address disparities and ensure equitable access to health services. Health professionals and policymakers in Albania and elsewhere should be aware of the unmet needs for healthcare services due to lack of awareness to navigate the system particularly among disadvantaged population groups.