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.

Autor: Ayanore MA; Mental Health and Wellness Study Group, Ho, Ghana. mayanore@uhas.edu.gh.; Department of Health Policy Planning and Management, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Ho, Ghana. mayanore@uhas.edu.gh., Adjuik M; Department of Epidemiology and Biostatistics, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Ho, Ghana., Zuñiga RAA; Mental Health and Wellness Study Group, Ho, Ghana.; University of Sierra, Sur. Oaxaca, Mexico., Amuna P; Fred N. Binka School of Public Health, University of Health and Allied Sciences, Ho, Ghana., Ezechi O; Mental Health and Wellness Study Group, Ho, Ghana.; Department of Social Medicine, Population and Public Health, University of California, Riverside School of Medicine, Riverside, CA, United States of America., Brown B; Mental Health and Wellness Study Group, Ho, Ghana.; Department of Clinical Sciences, Nigerian Institute of Medical Research, Lagos, Nigeria., Uzochukwu B; Mental Health and Wellness Study Group, Ho, Ghana.; University of Nigeria Nsukka (UNN) Enugu Campus, Nsukka, Nigeria., Aly NM; Mental Health and Wellness Study Group, Ho, Ghana.; Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt., Quadri MFA; Mental Health and Wellness Study Group, Ho, Ghana.; Texas Tech University and Health Sciences Center, Texas, United States of America., Popoola BO; Mental Health and Wellness Study Group, Ho, Ghana.; Department of Child Oral Health, University of Ibadan, Ibadan, Nigeria., Ishabiyi AO; Mental Health and Wellness Study Group, Ho, Ghana.; Department of Sociology, Florida Atlantic University, Boca Raton, Florida, USA., Ellakany P; Mental Health and Wellness Study Group, Ho, Ghana.; Department of Substitutive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia., Yousaf MA; Mental Health and Wellness Study Group, Ho, Ghana.; Institute of Zoology, University of the Punjab, Lahore, Pakistan., Virtanen JI; Mental Health and Wellness Study Group, Ho, Ghana.; Faculty of Medicine, University of Bergen, Bergen, Norway., Lawal FB; Mental Health and Wellness Study Group, Ho, Ghana.; Department of Periodontology and Community Dentistry, University of Ibadan and University College Hospital, Ibadan, Nigeria., Ara E; Mental Health and Wellness Study Group, Ho, Ghana.; Government College for Women, Srinagar, Kashmir (J&K), India., Khan AT; Mental Health and Wellness Study Group, Ho, Ghana.; Department of Biological Sciences, Faculty of Allied Health Sciences, Superior University, Kot Araian, Raiwind Road, Lahore, Punjab, Pakistan.; School of Biological Sciences, University of the Punjab, Quaid-e-Azam Campus, Lahore, Punjab, Pakistan., Gaffar B; Mental Health and Wellness Study Group, Ho, Ghana.; Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia., El Tantawi M; Mental Health and Wellness Study Group, Ho, Ghana.; Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt., Nguyen AL; Mental Health and Wellness Study Group, Ho, Ghana.; Department of Family Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States of America., Foláyan MO; Mental Health and Wellness Study Group, Ho, Ghana.; Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife, Nigeria.
Jazyk: angličtina
Zdroj: BMC public health [BMC Public Health] 2024 Feb 13; Vol. 24 (1), pp. 455. Date of Electronic Publication: 2024 Feb 13.
DOI: 10.1186/s12889-024-17912-4
Abstrakt: 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.
(© 2024. The Author(s).)
Databáze: MEDLINE
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