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Kumah E, Asana Y, Agyei SK, Kokuro C, Ankomah SE, Fusheini A. Does health insurance status influence healthcare-seeking behavior in rural communities? evidence from rural Ghana. HEALTH POLICY OPEN 2024; 6:100119. [PMID: 38680189 PMCID: PMC11047188 DOI: 10.1016/j.hpopen.2024.100119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 03/12/2024] [Accepted: 04/15/2024] [Indexed: 05/01/2024] Open
Abstract
Introduction National health insurance programs are considered important mechanisms for ensuring equity in access to and utilization of healthcare services by removing financial barriers associated with seeking treatment in healthcare facilities. Although studies on health insurance schemes in many low-and-middle-income countries (LMICs) have demonstrated a significant relationship between health insurance status and healthcare-seeking behavior, data on the influence of this health financing policy on the decision to seek formal healthcare among rural inhabitants remains limited. Underpinned by the Andersen-Newman behavioral model of healthcare use, this study examined the influence of health insurance status on healthcare-seeking behavior among rural dwellers in Ghana. Methods A community-based cross-sectional study was conducted among 460 rural residents in Ghana from 8th September to 5th December 2022. Chi-square tests were used to study the significance level and association between healthcare-seeking behavior and selected independent variables. A multiple logistic regression model was fitted to test the association between health insurance status and healthcare-seeking behavior, introducing other selected explanatory variables as controls. Results The mean age of the respondents was 29.6 ± 6.8 years. A little above half (53.1 %) disclosed having insurance, whereas 46.1 % stated they were without coverage. Regarding healthcare-seeking behavior, the most commonly chosen treatment source was traditional healers (37.2 %), followed by the public healthcare system (28.3 %) and self-treatment (18.2 %). The private healthcare system was the least preferred, with only 16.3 % opting for it. While the bivariate analysis demonstrated a significant relationship between health insurance status and healthcare-seeking behavior (p-0.001), the logistic regression model results showed that health insurance status was not an independent predictor of healthcare-seeking behavior (p = 0.069). Conclusion It could, therefore, not be concluded that the respondents with health insurance coverage were more likely than the uninsured to use formal healthcare providers as their most frequent source of treatment during illness. This study provides vital information for policymakers aiming at increasing access to and utilization of facility-based formal care in rural and remote settings.
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Affiliation(s)
- Emmanuel Kumah
- Department of Health Administration and Education, Faculty of Science Education, University of Education, Winneba, Ghana
| | - Yussif Asana
- Department of Public Health, Faculty of Health Sciences, Catholic University, Ghana
| | - Samuel Kofi Agyei
- Department of Public Health, Presbyterrian University, Ghana, Asante Akyem Campus, Agogo, Ghana
| | - Collins Kokuro
- Department of Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Samuel E. Ankomah
- Obstetrics and Gynecology Directorate, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Adam Fusheini
- Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
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Agyemang-Duah W, Braimah JA, Asante D, Appiah JO, Peprah P, Awuviry-Newton K, Mensah AA, Ofori-Amoah J, Opoku K. Family Support, Perceived Physical Activeness and Chronic Non-Communicable Diseases as Determinants of Formal Healthcare Utilization Among Older Adults with Low Income and Health Insurance Subscription in Ghana. J Aging Soc Policy 2024; 36:658-674. [PMID: 37724601 DOI: 10.1080/08959420.2023.2255488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 06/08/2023] [Indexed: 09/21/2023]
Abstract
Evidence suggests that enrollment in a health insurance scheme is associated with higher levels of formal healthcare utilization among older adults, especially those with low income in sub-Saharan Africa (SSA), including Ghana. This study examines the prevalence of formal healthcare utilization and associated factors among older adults with low income and health insurance subscription enrolled in a social intervention program (known as the Livelihood Empowerment Against Poverty [LEAP] program) in Ghana. Cross-sectional data were obtained from an Aging, Health, Lifestyle and Health Services Survey conducted in 2018 among 200 older adults aged 65 years and above enrolled in the LEAP program. The results showed that almost 9 in 10 (87%) older adults utilized formal healthcare services for their health problems. Older adults who received family support, rated themselves to be physically active and had non-communicable diseases (NCDs) were more significantly likely to utilise formal health care services than their counter parts. We recommend that health policies and programs for older adults with low income and health insurance subscription under the LEAP program should consider the roles of family support, physical activeness and NCDs in influencing their use of formal healthcare services.
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Affiliation(s)
| | | | - Dennis Asante
- College of Medicine & Public Health, Rural and Remote Health, Flinders University, Renmark, South Australia
| | - Joseph Oduro Appiah
- School of Environmental Planning, University of Northern British Columbia, Prince George, BC, Canada
| | - Prince Peprah
- Social Policy Research Centre, Centre for Primary Health Care and Equity, The University of New South Wales, Sydney, Australia
| | - Kofi Awuviry-Newton
- Priority Research Centre for Generational Health and Ageing, School of Medicine and Health, University of Newcastle, Callaghan, Australia
| | - Anthony Acquah Mensah
- Department of Planning, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Kwabena Opoku
- Social Science Department, Okomfo Anokye Senior High School, Wiamoase-Ashanti Region, Ghana
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Amoak D, Antabe R, Braimah JA, Agyemang-Duah W, Sano Y, Luginaah I. Exploring the association of self-rated oral health with self-rated general and mental health among older adults in a resource-poor context: Insights for advancing Sustainable Development Goal 3. SPECIAL CARE IN DENTISTRY 2024. [PMID: 38863160 DOI: 10.1111/scd.13033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 04/27/2024] [Accepted: 06/02/2024] [Indexed: 06/13/2024]
Abstract
INTRODUCTION Older adults in Ghana have been disproportionately affected by oral health issues such as caries and periodontitis. This situation calls for comprehensive attention within health and healthcare policies, due to the established connections between oral health and other aspects of health and well-being in high-income countries, including physical and mental health. However, there is a significant gap in the literature when it comes to exploring the association of oral health with physical and mental health in resource-constrained settings like Ghana. METHODS To address this void, we collected a cross-sectional sample comprising older adults aged 60 and above (n = 1073) and analyzed self-rated health measures to investigate the relationship between oral health and general and mental health in Ghana. RESULTS The results of our logistic regression analysis revealed a significant association: older adults who reported poor oral health were more likely to rate their general (OR = 5.10; p < .001) and mental health (OR = 4.78, p < .001) as poor, compared to those with good oral health, even after accounting for demographic and socioeconomic variables. CONCLUSIONS Based on these findings, we discuss the policy implications of our findings, especially in the context of advancing Sustainable Development Goal 3 in Ghana and other resource-constrained settings.
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Affiliation(s)
- Daniel Amoak
- Department of Geography and Environment, Western University, London, Canada
| | - Roger Antabe
- Department of Health and Society, University of Toronto Scarborough, Scarborough, Canada
| | | | | | - Yujiro Sano
- Department of Sociology and Anthropology, Nipissing University, North Bay, Canada
| | - Isaac Luginaah
- Department of Geography and Environment, Western University, London, Canada
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Tehrani JM, Vos IA, Kisabacak R, Topper MK, Steinhorst J, Phillips RO, Abass KM, Osei-Mireku S, Anokye CO, Adu Poku JK, Stienstra Y, Amoako YA. Traditional healers' perception on scabies causation and management in Ghana. Trop Med Int Health 2024; 29:477-488. [PMID: 38599337 DOI: 10.1111/tmi.13989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
INTRODUCTION Scabies is an underdiagnosed skin infestation caused by the Sarcoptes scabiei mite. The infection causes severe itching and a skin rash but can be effectively treated using topical or systemic drugs. Scabies outbreaks are commonly reported in resource-poor countries, including Ghana. Traditional healers play an important role in primary care in rural areas. The role of these traditional healers in the management of scabies has so far not been explored. The aim of this study was therefore to investigate the perceptions of traditional healers regarding the causation and management of scabies. METHODS A phenomenological qualitative approach was employed. Traditional healers in the Asante Akim North and Central districts in Ghana were approached with an interview request. Using a semi-structured interview protocol, 15 traditional healers were interviewed. The results were coded and analysed, after which seven themes were extrapolated. RESULTS Scabies infections were frequently reported by traditional healers. Itching and skin rash were unanimously regarded as the major symptoms of scabies. The majority acknowledged the infectious nature of scabies, but no participant reported the causative organism. A dichotomous disease classification was noted, consisting of 'natural' and 'spiritual' variants each with a unique disease profile and management requirements, as reported by the traditional healers. All but two traditional healers reported to treat scabies using almost exclusively herbs and spiritual rituals. CONCLUSION The majority of traditional healers were open to collaboration with allopathic healthcare providers. Collaboration could broaden the primary care network in rural areas, but mistrust and lack of transparency form potential barriers to collaboration. We, therefore, emphasise the need for additional efforts to investigate strategies for future collaboration.
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Affiliation(s)
- Jian M Tehrani
- Department of Internal Medicine/Infectious Diseases, University Medical Centre Groningen, Groningen, The Netherlands
| | - Ingmar A Vos
- Department of Internal Medicine/Infectious Diseases, University Medical Centre Groningen, Groningen, The Netherlands
| | - Robin Kisabacak
- Department of Internal Medicine/Infectious Diseases, University Medical Centre Groningen, Groningen, The Netherlands
| | - Marten K Topper
- Department of Internal Medicine/Infectious Diseases, University Medical Centre Groningen, Groningen, The Netherlands
| | - Jonathan Steinhorst
- Department of Internal Medicine/Infectious Diseases, University Medical Centre Groningen, Groningen, The Netherlands
| | - Richard Odame Phillips
- Kumasi Centre for Collaborative Research, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Samuel Osei-Mireku
- Agogo Presbyterian Hospital, Agogo, Ghana
- The Trust Hospital, Accra, Ghana
| | | | | | - Ymkje Stienstra
- Department of Internal Medicine/Infectious Diseases, University Medical Centre Groningen, Groningen, The Netherlands
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Yaw Ampem Amoako
- Department of Internal Medicine/Infectious Diseases, University Medical Centre Groningen, Groningen, The Netherlands
- Kumasi Centre for Collaborative Research, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Tuck CZ, Cooper R, Aryeetey R, Gray LA, Akparibo R. A critical review and analysis of the context, current burden, and application of policy to improve cancer equity in Ghana. Int J Equity Health 2023; 22:254. [PMID: 38066530 PMCID: PMC10709985 DOI: 10.1186/s12939-023-02067-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 11/26/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Cancer causes a major disease burden worldwide. This is increasingly being realised in low and middle-income countries, which account disproportionately for preventable cancer deaths. Despite the World Health Organization calling for governments to develop policies to address this and alleviate cancer inequality, numerous challenges in executing effective cancer policies remain, which require consideration of the country-specific context. As this has not yet been considered in Ghana, the aim of this review was to bring together and critique the social-environmental, health policy and system factors to identifying opportunities for future health policies to reduce cancer burden in the Ghanian context. A critical policy-focused review was conducted to bring together and critique the current health systems context relating to cancer in Ghana, considering the unmet policy need, health system and social factors contributing to the burden and policy advances related to cancer. CONCLUSION The findings highlight the changing burden of cancer in Ghana and the contextual factors within the socio-ecosystem that contribute to this. Policies around expanding access to and coverage of services, as well as the harmonization with medical pluralism have potential to improve outcomes and increase equity but their implementation and robust data to monitor their impact pose significant barriers.
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Affiliation(s)
- Chloe Zabrina Tuck
- School of Medicine and Population Health, University of Sheffield, 30 Regent Street, Sheffield, S1 4DA, UK.
- School of Public Health, University of Ghana, Accra, Ghana.
| | - Richard Cooper
- School of Medicine and Population Health, University of Sheffield, 30 Regent Street, Sheffield, S1 4DA, UK
| | | | - Laura A Gray
- School of Medicine and Population Health, University of Sheffield, 30 Regent Street, Sheffield, S1 4DA, UK
| | - Robert Akparibo
- School of Medicine and Population Health, University of Sheffield, 30 Regent Street, Sheffield, S1 4DA, UK.
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James PB, Gyasi RM, Kasilo OMJ, Wardle J, Bah AJ, Yendewa GA, Mwaka AD. The use of traditional medicine practitioner services for childhood illnesses among childbearing women: a multilevel analysis of demographic and health surveys in 32 sub-Saharan African countries. BMC Complement Med Ther 2023; 23:137. [PMID: 37120536 PMCID: PMC10148432 DOI: 10.1186/s12906-023-03972-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 04/25/2023] [Indexed: 05/01/2023] Open
Abstract
BACKGROUND Insights into the use of traditional medicine practitioners (TMP)-for common childhood diseases such as diarrhea and respiratory infections are important to understand the role of Traditional Medicine (TM) in reducing the increasing childhood morbidity and mortality in sub-Saharan Africa (SSA). However, a comprehensive picture of TMP utilisation and its associated factors for childhood illness in SSA is lacking. This study aimed to estimate the prevalence of the use of traditional medicine practitioner services to treat childhood illnesses among women with children under five years old and to identify individual and community-level factors associated with TMP use in SSA. METHODS The analysis used Demographic and Health Surveys (DHS) dataset collected between 2010 and 2021 among 353,463 under-fives children from 32 SSA countries. Our outcome variable was the use of TMP for childhood illness, defined as having diarrhoea or fever/cough or both. Using STATA v14, we employed the random effect meta-analysis to estimate the pooled prevalence of TMP use for childhood illness and a two-level multivariable multilevel modelling to determine the individual and community-level factors associated with consultation of a TMP. RESULTS Approximately [2.80% (95%CI: 1.88-3.90)] women who sought healthcare for childhood illnesses utilised the service of a TMP with the highest occurring in Cote d'Ivoire [16.3% (95%CI: 13.87-19.06)] and Guinea (13.80% (95%CI: 10.74-17.57)] but the lowest in Sierra Leone [0.10%(95%CI:0.01-1.61)]. Specifically, approximately [1.95% (95%CI: 1.33-2.68)] and [1.09% (95%CI:0.67-1.60)] of women sought the service of a TMP for childhood diarrhea and fever/cough, respectively. Women with no formal education [AOR = 1.62;95%CI:1.23-2.12], no media access [AOR = 1.19;95%CI:1.02-1.39), who lived in a male-headed household [AOR = 1.64;95%CI:1.27-2.11], without health insurance [AOR = 2.37;95%CI: 1.53-3.66], who considered it a problem getting permission to visit a health facility [AOR = 1.23;95%CI:1.03-1.47] and who perceived the size of their children at birth to be above average[AOR = 1.20;95%CI:1.03-1.41] had higher odds of using TMP for childhood illnesses. CONCLUSIONS Although the prevalence of TMP for childhood illnesses appeared low, our findings highlight that TMPs continue to play a critical role in managing childhood illnesses in SSA. It is essential that policymakers and service providers should incorporate the potential role of TMPs in the design, review and implementation of child health policies in SSA. Also, the interventions for curtailing childhood illnesses should be focused on the characteristics of women who use TMPs for childhood diseases identified in our study.
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Affiliation(s)
- Peter Bai James
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, NSW, 2480, Australia.
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.
| | - Razak M Gyasi
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, NSW, 2480, Australia
- African Population and Health Research Center (APHRC), Nairobi, Kenya
| | - Ossy Muganga Julius Kasilo
- WHO Regional Office for Africa, Universal Health Coverage Life Course Cluster, Brazzaville, Republic of Congo
| | - Jon Wardle
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, NSW, 2480, Australia
| | - Abdulai Jawo Bah
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
- Institute for Global Health and Development, Queen Margaret University Edinburg, Musselburgh, Scotland, UK
| | - George A Yendewa
- Division of Infectious Diseases and HIV Medicine, University Hospitals Cleveland Medical Center, Cleveland, OH, 44106, USA
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
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Amoak D, Braimah JA, Agyemang-Duah W, Kye NO, Anfaara FW, Sano Y, Antabe R. Understanding the Link between Household Food Insecurity and Self-Rated Oral Health in Ghana. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:ijerph20010121. [PMID: 36612441 PMCID: PMC9819873 DOI: 10.3390/ijerph20010121] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 12/15/2022] [Accepted: 12/16/2022] [Indexed: 05/31/2023]
Abstract
There is increasing scholarly attention on the role of food insecurity on the health of older adults in sub-Saharan Africa, including Ghana. Yet, we know very little about the association between food insecurity and self-rated oral health. To address this void in the literature, this study uses a representative survey of adults aged 60 or older from three regions in Ghana to examine whether respondents who experienced household food insecurity rated their oral health as poor compared to their counterparts who did not. We found that 34% of respondents rated their oral health as poor, while 7%, 21%, and 36% experienced mild, moderate, and severe food insecurity, respectively. Moreover, the results from the logistic regression analysis showed that older adults who experienced mild (OR = 1.66, p < 0.05), moderate (OR = 2.06, p < 0.01), and severe (OR = 2.71, p < 0.01) food insecurity were more likely to self-rate their oral health as poor, compared to those who did not experience any type of food insecurity. Based on these findings, we discuss several implications for policymakers and directions for future research.
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Affiliation(s)
- Daniel Amoak
- Department of Geography and Environment, Western University, London, ON N6A 5C2, Canada
| | - Joseph Asumah Braimah
- Department of Health and Society, University of Toronto Scarborough, Scarborough, ON M1C 1A4, Canada
| | | | - Nancy Osei Kye
- Department of Gender, Sexuality, and Women’s Studies, Western University, London, ON N6A 5B8, Canada
| | - Florence Wullo Anfaara
- Department of Gender, Sexuality, and Women’s Studies, Western University, London, ON N6A 5B8, Canada
| | - Yujiro Sano
- Department of Sociology and Anthropology, Nipissing University, North Bay, ON P1B 8L7, Canada
| | - Roger Antabe
- Department of Health and Society, University of Toronto Scarborough, Scarborough, ON M1C 1A4, Canada
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Tuck CZ, Akparibo R, Gray LA, Aryeetey RNO, Cooper R. What influences cancer treatment service access in Ghana? A critical interpretive synthesis. BMJ Open 2022; 12:e065153. [PMID: 36198450 PMCID: PMC9535186 DOI: 10.1136/bmjopen-2022-065153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES Multiple social-cultural and contextual factors influence access to and acceptance of cancer treatment in Ghana. The aim of this research was to assess existing literature on how these factors interplay and could be susceptible to local and national policy changes. DESIGN This study uses a critical interpretive synthesis approach to review qualitative and quantitative evidence about access to adult cancer treatment services in Ghana, applying the socioecological model and candidacy framework. RESULTS Our findings highlighted barriers to accessing cancer services within each level of the socioecological model (intrapersonal, interpersonal community, organisational and policy levels), which are dynamic and interacting, for example, community level factors influenced individual perceptions and how they managed financial barriers. Evidence was lacking in relation to determinants of treatment non-acceptance across all cancers and in the most vulnerable societal groups due to methodological limitations. CONCLUSIONS Future policy should prioritise multilevel approaches, for example, improving the quality and affordability of medical care while also providing collaboration with traditional and complementary care systems to refer patients. Research should seek to overcome methodological limitations to understand the determinants of accessing treatment in the most vulnerable populations.
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Affiliation(s)
- Chloe Zabrina Tuck
- School of Health and Related Research (ScHARR), The University of Sheffield, Sheffield, UK
| | - Robert Akparibo
- School of Health and Related Research (ScHARR), The University of Sheffield, Sheffield, UK
| | - Laura A Gray
- School of Health and Related Research (ScHARR), The University of Sheffield, Sheffield, UK
| | | | - Richard Cooper
- School of Health and Related Research (ScHARR), The University of Sheffield, Sheffield, UK
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Danquah L, Amegbor PM, Ayele DG. Determinants of the type of health care sought for symptoms of Acute respiratory infection in children: analysis of Ghana demographic and health surveys. BMC Pediatr 2021; 21:514. [PMID: 34789184 PMCID: PMC8597276 DOI: 10.1186/s12887-021-02990-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 11/03/2021] [Indexed: 11/10/2022] Open
Abstract
Background Globally, acute respiratory infection (ARI) is a leading cause of infant and childhood morbidity and mortality. Currently, it is estimated that 50 million cases of childhood ARI are untreated. In this study, we identified determinants of the type of treatment sought for symptoms of childhood acute respiratory infection (ARI), including non-treatment, amongst a nationally representative sample of children under five years in Ghana. Methods In total, 1 544 children were studied by a secondary analysis of pooled survey data from the 1993, 1998, 2003, 2008, and 2014 Ghana Demographic and Health Surveys (GDHS). Cross-tabulations, chi-square, multinomial logistic regression, and Bayesian hierarchical spatial logistic regression analyses were used to identify relationships between the type of treatment sought and maternal socio-economic and household characteristics. Results Seeking medical care was significantly associated with child age (RRR= 1.928, 95 % CI 1.276 – 2.915), maternal employment status (RRR = 1.815, 95 % CI 1.202 – 2.740), maternal health insurance status, (RRR = 2.618, 95 % CI 1.801 – 3.989), children belonging to middle (RRR = 2.186, 95 % CI 1.473 – 3.243), richer (RRR = 1.908, 95 % CI 1.145 – 3.180) and richest households (RRR = 2.456, 95 % CI 1.363 – 4.424) and the 1998 survey period (RRR = 0.426, 95 % CI 0.240 – 7.58). Seeking self-care or visiting a traditional healer was significantly associated with maternal educational status (RRR = 0.000, 95 % CI 0.000 – 0.000), and the 1998 (RRR= 0.330, 95 % CI 0.142 – 0.765), 2003 (RRR= 0.195, 95 % CI 0.071 – 0.535), 2008 (RRR= 0.216, 95 % CI 0.068 – 0.685) and 2014 (RRR= 0.230, 95 % CI 0.081 – 0.657) GDHS periods. The probability that the odds ratio of using medical care exceeded 1 was higher for mothers/caregivers in the Western, Ashanti, Upper West, and Volta regions. Conclusions Government policies that are aimed at encouraging medical care-seeking for children with ARI may yield positive results by focusing on improving maternal incomes, maternal NHIS enrolment, and maternal household characteristics. Improving maternal education could be a positive step towards addressing challenges with self-care or traditional healing amongst children with ARI.
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Affiliation(s)
- Leslie Danquah
- Department of Geographic Science, School of Geosciences, University of Energy and Natural Resources, Sunyani, Ghana.
| | | | - Dawit Getnet Ayele
- Institute of Human Virology, School of Medicine, University of Maryland, Baltimore, USA
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