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. 2024 Feb 13;24(1):455.
doi: 10.1186/s12889-024-17912-4.

Economic and social determinants of health care utilization during the first wave of COVID-19 pandemic among adults in Ghana: a population-based cross-sectional study

Martin Amogre Ayanore  1   2 , Martin Adjuik  3 , Roberto Ariel Abeldaño Zuñiga  4   5 , Paul Amuna  6 , Oliver Ezechi  4   7 , Brandon Brown  4   8 , Benjamin Uzochukwu  4   9 , Nourhan M Aly  4   10 , Mir Faeq Ali Quadri  4   11 , Bamidele Olubukola Popoola  4   12 , Anthonia Omotola Ishabiyi  4   13 , Passent Ellakany  4   14 , Muhammad Abrar Yousaf  4   15 , Jorma I Virtanen  4   16 , Folake Barakat Lawal  4   17 , Eshrat Ara  4   18 , Abeedha Tu-Allah Khan  4   19   20 , Balgis Gaffar  4   21 , Maha El Tantawi  4   10 , Annie L Nguyen  4   22 , Moréniké Oluwátóyìn Foláyan  4   23
Affiliations

Economic and social determinants of health care utilization during the first wave of COVID-19 pandemic among adults in Ghana: a population-based cross-sectional study

Martin Amogre Ayanore et al. BMC Public Health. .

Abstract

Background: The COVID-19 pandemic had socioeconomic effects in Africa. This study assessed the social and economic determinants of healthcare utilization during the first wave of COVID-19 among adults in Ghana.

Methods: Information about individuals residing in Ghana was derived from a survey conducted across multiple countries, aiming to evaluate the impact of the COVID-19 pandemic on the mental health and overall well-being of adults aged 18 and above. The dependent variable for the study was healthcare utilization (categorized as low or high). The independent variables were economic (such as financial loss, job loss, diminished wages, investment/retirement setbacks, and non-refunded travel cancellations) and social (including food scarcity, loss of financial support sources, housing instability, challenges affording food, clothing, shelter, electricity, utilities, and increased caregiving responsibilities for partners) determinants of health. A multinomial logistic regression was conducted to identify factors associated with healthcare utilization after adjusting for confounders (age, gender, access to medical insurance, COVID-19 status, educational background, employment, and marital status of the participants).

Results: The analysis included 364 responses. Individuals who encountered a loss of financial support (AOR: 9.58; 95% CI: 3.44-26.73; p < 0.001), a decrease or loss of wages (AOR: 7.44, 95% CI: 3.05-18.16, p < 0.001), experienced investment or retirement setbacks (AOR: 10.69, 95% CI: 2.60-43.88, p = 0.001), and expressed concerns about potential food shortages (AOR: 6.85, 95% CI: 2.49-18.84, p < 0.001) exhibited significantly higher odds of low healthcare utilization during the initial phase of the pandemic. Contrastingly, participants facing challenges in paying for basic needs demonstrated lower odds of low healthcare utilization compared to those who found it easy to cover basic expenses (AOR: 0.19, 95% CI: 0.06-0.67, p = 0.001).

Conclusion: Economic and social factors were associated with low healthcare utilization in Ghana during the first wave of the pandemic. Investment or retirement loss and financial support loss during the pandemic had the largest effect on healthcare utilization. Further research is needed to understand the connection between concerns about food shortages, welfare losses during pandemics and healthcare utilization during pandemics in Ghana.

Keywords: COVID-19; Economic determinants; Ghana; Health care utilization; Social determinants.

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Conflict of interest statement

Martin Ayanore is an Associate Editor, at BMC Public Health while Morenike Oluwatoyin Folayan and Maha El Tantawi are Senior Board Members with BMC Oral Health. Jorma Virtanen is an Associate Editor, at BMC Oral Health. All other authors declare no conflict of interest.

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