Demography, Socioeconomic Status and Health Services Utilisation among Older Ghanaians: Implications for Health Policy
Although socioeconomic status (SES) has long been linked with health services utilisation, the associations of demographic factors and SES, and multiple healthcare options in later life remain unclear. This paper utilised a large and representative dataset from a 2016/17 Ageing, Health, Psychological Wellbeing and Health-seeking Behaviour Study (AHPWHB) to examine the effects of multilevel SES and demographic inequalities in health-seeking behaviour among a community sample of Ghanaians aged 50 years or older. Multiple logistic models estimated gendered-stratified SES effects on utilisation of various healthcare options, including formal healthcare, traditional medicine and self-care. Interestingly, urban living decreased the odds of formal healthcare use but increased self-care across genders. Married women were less likely to utilise formal and traditional healthcare but married men predominantly accessed formal healthcare. Age, education and health insurance independently predicted utilisation of differing healthcare types. Information on SES inequalities including geographical variations, marital status and gendered perspective appears to be useful in planning health and delivery strategies for older persons.
KeywordsGeographical variation Health policy Health-seeking behaviour Older persons Formal healthcare; traditional medicine
RM Gyasi conceived and designed the study under the PhD supervision of DR Phillips. RM Gyasi supervised the fieldwork, analysed the data and wrote the initial version of the manuscript. RM Gyasi and DR Phillips undertook critical review and revision of the manuscript. Both authors read and approved the final manuscript.
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by Lingnan University, Hong Kong, through its Studentships for Research Postgraduates [RPG1129310]. The sponsor had no role in the study or manuscript writing.
Compliance with Ethical Standards
Conflict of Interest
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Study participants were carefully and fully briefed on the research objectives and they provided informed consent. In line with ethics approval, oral informed consent was received from each participant prior to the interview.
Ethical Treatment of Experimental Subjects (Animal and Human)
In line with the Declaration of Helsinki, the study protocol was provided by the Committee on Human Research Publication and Ethics, School of Medical Sciences, Kwame Nkrumah University of Science and Technology and Komfo Anokye Teaching Hospital, Kumasi, Ghana (Ref: CHRPE/AP/507/16). The Research Ethics Committee of Lingnan University, Hong Kong also granted ethical approval for this study.
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