Digital access as a conditional resource: Women's barriers to health care in 20 Demographic and Health Surveys

Digital technologies are often framed as tools for expanding access to health information, services, and resources. Yet access to digital tools may not translate into care-seeking capacity when women face gendered household constraints. This article examines whether women's digital access is associated with four reported barriers to health care: needing permission for treatment, not wanting to go alone, getting money for treatment, and distance to a health facility. Drawing on recent women's individual recode data from 20 Demographic and Health Survey countries with observed health-care access barrier outcomes, I analyse 379,293 women and 1,387,700 stacked woman-barrier observations. Weighted linear probability models include DHS survey fixed effects, barrier fixed effects, individual socioeconomic controls, within-survey normalized DHS weights, and standard errors clustered by DHS cluster, with additional robustness checks for woman-level and two-way clustering. The results show a barrier-specific pattern. Mobile phone ownership and recent internet use are consistently associated with lower reporting of money and distance barriers, but not with lower reporting of permission or going-alone barriers. Internet use is associated with 8.9 percentage points lower reporting of money barriers and 10.0 percentage points lower reporting of distance barriers, while its associations with permission and going-alone barriers are not negative. These observational patterns are consistent with a conditional-resource account: digital access is most strongly associated with lower barriers where information, communication, money mobilization, or travel planning are most directly actionable.