Strengthening healthcare access for adolescent and young adult women: a narrative review of determinants, health system challenges, and emerging strategies for equitable care

Background Due to biological, social, economic, cultural, geographic, and health system restrictions that restrict timely access to high-quality healthcare, adolescent and young adult (AYA) women face significant health disparities. Particularly in low- and middle-income countries, these issues lead to unnecessary maternal morbidity and death, mental health concerns, infectious and non-communicable conditions, and poor sexual and reproductive health. Therefore, achieving the Sustainable Development Goals (SDGs) and Universal Health Coverage (UHC) requires improving equal access to healthcare. Objective To synthesize the available literature on the factors influencing healthcare access, health system challenges, and emerging strategies affecting equitable healthcare utilization among adolescent and young adult women, with emphasis on policy priorities and future research directions. Review approach A narrative review approach was used to synthesize the literature on healthcare access among AYA women. The review considers conceptual frameworks of healthcare access and organizes the literature thematically across individual, sociocultural, economic, geographic, reproductive, mental health, digital, and health-system determinants, as well as vulnerable populations, emerging interventions, policy recommendations, and future research priorities. Discussion The review shows how complex relationships between individual traits, socioeconomic variables and health system factors influence AYA women's access to healthcare. Insufficient health literacy, gender inequality, poverty, high expenses, insufficient insurance, transportation challenges, stigma, a lack of workers, insufficient facilities, a lack of adolescent-friendly services and the digital divide are all significant obstacles. Accessibility may be further enhanced by new strategies including telemedicine, mobile health technology, artificial intelligence, integrated healthcare models, youth- friendly clinics, community engagement and universal health coverage. Coordinated multisectoral policies, improved healthcare systems, digital inclusion, financial security, and culturally sensitive services catered to the needs of young women and teens are necessary for successful implementation, despite this. Conclusion Equitable healthcare access for teenage and young adult women requires integrated, patient-centered, and evidence-based treatments that address structural, financial, societal, and technological barriers simultaneously. Reducing healthcare disparities, increasing healthcare utilization, and achieving long-term improvements in the health and well-being of AYA women worldwide require investments in adolescent-friendly healthcare services, digital health innovations, strengthening the health system, gender responsive policies, and implementation research.