Rationale and Background: : The COVID-19 pandemic posed a significant global public health challenge, affecting health care access and provision across all age groups. With limited literature available on its impact in Lao PDR. Objectives: : to investigate individuals’ confidence of in accessing health care services before, during, and after the pandemic. Methodology: : A cross-sectional study was conducted in three provinces (Vientiane, Luangprabang and Champasak) using a multi-stage household sampling approach. A total 2,300 participants were recruited, including youth (15-24 years old), adults (25–59 years old) and elderly people (60–75 years old). Data were collected through face-to-face structured interviews, covering health care access before, during and after the pandemic, together with characteristics of individual, household, community and policy-related factors. Descriptive and multiple logistic regression analyses were performed to determine factors associated with confidence to access health services among individuals. Results: : The study recruited 545 youths, 1,370 adults and 385 elderly people (female 51.7%, 54.2% and 55.1% respectively). Nearly half of participants had poor COVID literacy (48.4%). Nearly three-quarters (71.3%) had a high level of depression-anxiety-stress scale (DASS) related to COVID. More than one-third of participants (36.7%) had a reduction of confidence to access health care (youth: 36.3%, adult: 36.4% and elders: 38.2%). Factors associated with reduced confidence varied across age groups and levels. Key influencing factors included high COVID-related DASS scores, difficulties in seeking care, insufficient information, lack of a supportive person or community, and having a family member with a chronic-illness. Conclusion: To maintain confidence in healthcare access, adequate information dissemination must be prioritized, particularly in communities with limited accessibility and households with ill members. Future research should focus on health system preparedness and community engagement in response to future public health emergencies.