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. 2025 Jun 26;23(Suppl 2):31.
doi: 10.1186/s12963-025-00389-7.

The impact of the COVID-19 pandemic on all-cause mortality and life expectancy in northern Ghana: findings from the Navrongo Health and Demographic Surveillance System

Daniel K Azongo  1 , Timothy Awine  2 , Chodziwadziwa W Kabudula  3 , Samuel Oladokun  2 , Beth A Tippett Barr  4 , Jean Bashingwa  3 , Bawa Ayaga  5 , Mumuni Abu  5 , Patrick Adum Ansah  2
Affiliations

The impact of the COVID-19 pandemic on all-cause mortality and life expectancy in northern Ghana: findings from the Navrongo Health and Demographic Surveillance System

Daniel K Azongo et al. Popul Health Metr. .

Abstract

Background: Measurement of excess mortality attributable to the COVID-19 pandemic is essential for quantifying the direct and indirect effects on mortality and informing future public health control strategies. This study assessed the impact of COVID-19 on excess mortality and life expectancy at birth in rural northern Ghana.

Methods: Data was obtained from the Navrongo Health and Demographic Surveillance System (NHDSS) in Ghana. We computed the number of deaths and person-years contributed from January 1, 2015, to December 31, 2021, and estimated mortality rates for each year, age group, and gender. Mortality rate differences were calculated by comparing the period before (2018-2019) and during (2020-2021) the pandemic. To estimate excess mortality, a generalised additive model was fitted to the historical data from 2015 to 2019 to predict the expected mortality rates in the COVID-19 period (2020-2021). A Cox proportional hazards model was fitted to assess the risk factors associated with mortality, adjusting for socio-demographic variables. Conventional life table techniques were used to estimate period life expectancy at birth for males and females.

Results: Overall, 12,413 deaths and 1,227,115 person-years were included in the analysis. This consists of 5,930 (49%) deaths and 572,963 person-years for the pre-pandemic period (2015-2019) and 6,483 (52%) deaths and 654,153 person-years for the pandemic period (2020-2021). From 2020 to 2021, the crude mortality rate was 23.9 deaths per 1000 person-years compared with 20.7 deaths per 1000 person-years predicted if COVID-19 had not occurred. COVID-19 also caused a decline in life expectancy at birth, especially in males, by 3.4 years. In addition, the adjusted risk of dying during the pandemic was higher in males (12.1%) compared to females and higher in the 65 + years age group (69.2%) compared to the younger population.

Conclusion: The COVID-19 pandemic caused an increase in deaths and a decrease in life expectancy in the NHDSS population in Ghana, particularly among men and those aged 65 years and older. These results reinforce the critical role of routine surveillance data in assessing the impact of public health emergencies such as the COVID-19 pandemic and informing public health strategies.

Keywords: COVID-19; Coronavirus; Excess mortality; Health and Demographic Surveillance Sites; Life expectancy; Mortality.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The Navrongo Health Research Centre Institutional Review Board (NHRC-IRB) granted ethical approval for collecting the Navrongo HDSS data with the registration number NHRC-IRB115. Before the start of data collection, community consent was obtained through engagement with traditional authorities, opinion leaders, and community members. Therefore, ethical approval and individual-level consent were not required for the current study, which was solely based on the analysis of secondary data. Consent for publication: Not available. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Trends in all-cause mortality by males and females from 2015 to 2021 in the Navrongo HDSS study area
Fig. 2
Fig. 2
Trends in all-cause mortality rates by age group (0–4, 5–14, 15–49, 50–64 and 65 + years) from 2015 to 2021 in the Navrongo HDSS study area
Fig. 3
Fig. 3
Monthly trends in excess mortality during the COVID-19 pandemic (2020–2021) (using outputs from the predictions of the Poisson generalised additive model) in the Navrongo HDSS study area
Fig. 4
Fig. 4
Monthly trends in excess mortality by gender during the COVID-19 pandemic (2020–2021) (using outputs from the predictions of the Poisson generalised additive model) in the Navrongo HDSS study area
Fig. 5
Fig. 5
Life expectancy at birth and age 15, 30, and 50 years and by gender from 2015–2021 in the Navrongo HDSS study area
Fig. 6
Fig. 6
Age contributions to changes in life expectancy from 2019 to 2021 in the Navrongo HDSS study area
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