Staying in or out? COVID-19-induced healthcare utilization avoidance and associated socio-demographic factors in rural India

Michael Safo Oduro; Prince Peprah; Anthony Kwame Morgan; Williams Agyemang-Duah

doi:10.1186/s12889-023-16282-7

Staying in or out? COVID-19-induced healthcare utilization avoidance and associated socio-demographic factors in rural India

BMC Public Health. 2023 Jul 27;23(1):1439. doi: 10.1186/s12889-023-16282-7.

Authors

Michael Safo Oduro¹, Prince Peprah^{2

3}, Anthony Kwame Morgan⁴, Williams Agyemang-Duah⁵

Affiliations

¹ Pfizer, Inc., Pharm Sci and PGS Statistics, 445 Eastern Point Rd, Groton, Connecticut, USA.
² Social Policy Research Center, UNSW, Sydney, Australia.
³ Center for Primary Health Care and Equity, UNSW, Sydney, Australia.
⁴ Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. anthoniomorgano280@gmail.com.
⁵ Department of Geography and Planning, Queen's University, K7L 3N6, Kingston, Ontario, Canada.

Abstract

Background: Although evidence on healthcare utilization avoidance during COVID-19 pandemic is emerging, such knowledge is limited in rural settings. An effective policy to the COVID-19 shocks and stresses in rural settings require empirical evidence to inform the design of health policies and programmes. To help overcome this evidence gap and also contribute to policy decisions, this study aimed at examining COVID-19-induced healthcare utilization avoidance and associated factors in rural India.

Methods: This study used the third-round data from the COVID-19-Related Shocks in Rural India survey conducted between 20-24 September, 2020 across six states. The outcome variable considered in this study was COVID-19-induced healthcare utilization avoidance. Multivariable Binary Logistic Regression Model via Multiple Imputation was used to assess the factors influencing COVID-19-induced healthcare utilization avoidance.

Results: Data on 4,682 respondents were used in the study. Of this, the prevalence of COVID-19-induced healthcare utilization avoidance was 15.5% in rural India across the six states. After adjusting for relevant covariates, participants from the Bihar State have significantly higher likelihood of COVID-19-induced healthcare utilization avoidance compared to those from the Andhra Pradesh. Also, participants whose educational level exceeds high school, those who use government hospital/clinic, engage in daily wage labour in agriculture have significantly higher odds of COVID-19-induced healthcare utilization avoidance compared to their counterparts.

Conclusion: Our study revealed that state of residence, type of health facility used, primary work activity and educational level were associated with COVID-19-induced healthcare utilization avoidance in rural India. The findings suggest that policy makers and public health authorities need to formulate policies and design interventions that acknowledge socioeconomic and demographic factors that influence healthcare use avoidance.

Keywords: COVID-19; India; Logistic models; Patient acceptance of healthcare; Prevalence; Socio-economic factors.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

COVID-19* / epidemiology
Humans
India / epidemiology
Pandemics
Patient Acceptance of Health Care
Prevalence
Surveys and Questionnaires