COVID-19 Preventive Practices, Psychological Distress, and Reported Barriers to Healthcare Access during the Pandemic among Adult Community Members in Sub-Saharan Africa: A Phone Survey

Nega Assefa, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
Yasir Y. Abdullahi, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
Elena C. Hemler, Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts.
Bruno Lankoande, Institut Supérieur des Sciences de la Population, University of Ouagadougou, Ouagadougou, Burkina Faso.
Isabel Madzorera, Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts.
Dongqing Wang, Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts.
Abbas Ismail, College of Natural and Mathematical Sciences, University of Dodoma, Dodoma, Tanzania.
Angela Chukwu, Department of Statistics, University of Ibadan, Ibadan, Nigeria.
Firehiwot Workneh, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia.
Frank Mapendo, Africa Academy for Public Health, Dar es Salaam, Tanzania.
Ourohiré Millogo, Nouna Health Research Center, Nouna, Burkina Faso.
Sulemana Watara Abubakari, Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo North Municipality, Bono East Region, Ghana.
Lawrence Gyabaa Febir, Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo North Municipality, Bono East Region, Ghana.
Isaac Lyatuu, Africa Academy for Public Health, Dar es Salaam, Tanzania.
Kassoum Dianou, Institut Supérieur des Sciences de la Population, University of Ouagadougou, Ouagadougou, Burkina Faso.
Till Baernighausen, Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts.
Abdramane Soura, Institut Supérieur des Sciences de la Population, University of Ouagadougou, Ouagadougou, Burkina Faso.
Kwaku Poku Asante, Department of Statistics, University of Ibadan, Ibadan, Nigeria.
Emily Smith, Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia.
Said Vuai, College of Natural and Mathematical Sciences, University of Dodoma, Dodoma, Tanzania.
Alemayehu Worku, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia.
Japhet Killewo, Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Mary Mwanyika-Sando, Africa Academy for Public Health, Dar es Salaam, Tanzania.
Yemane Berhane, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia.
Ali Sie, Nouna Health Research Center, Nouna, Burkina Faso.
Raji Tajudeen, Division of Public Health Institutes and Research, Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia.
Ayo Oduola, University of Ibadan Research Foundation, University of Ibadan, Ibadan, Nigeria.
Wafaie W. Fawzi, Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts.

Document Type

Journal Article

Publication Date

12-12-2022

Journal

The American journal of tropical medicine and hygiene

DOI

10.4269/ajtmh.22-0349

Abstract

The COVID-19 pandemic has had serious negative health and economic impacts in sub-Saharan Africa. Continuous monitoring of these impacts is crucial to formulate interventions to minimize the consequences of COVID-19. This study surveyed 2,829 adults in urban and rural sites among five sub-Saharan African countries: Burkina Faso, Ethiopia, Nigeria, Tanzania, and Ghana. Participants completed a mobile phone survey that assessed self-reported sociodemographics, COVID-19 preventive practices, psychological distress, and barriers to healthcare access. A modified Poisson regression model was used to estimate adjusted prevalence ratios (aPRs) and 95% CIs to investigate potential factors related to psychological distress and barriers to reduced healthcare access. At least 15.6% of adults reported experiencing any psychological distress in the previous 2 weeks, and 10.5% reported that at least one essential healthcare service was difficult to access 2 years into the pandemic. The majority of participants reported using several COVID-19 preventive methods, with varying proportions across the sites. Participants in the urban site of Ouagadougou, Burkina Faso (aPR: 2.29; 95% CI: 1.74-3.03) and in the rural site of Kintampo, Ghana (aPR: 1.68; 95% CI: 1.21-2.34) had a higher likelihood of experiencing any psychological distress compared with those in the rural area of Nouna, Burkina Faso. Loss of employment due to COVID-19 (aPR: 1.77; 95% CI: 1.47-2.11) was also associated with an increased prevalence of psychological distress. The number of children under 5 years in the household (aPR: 1.23; 95% CI: 1.14-1.33) and participant self-reported psychological distress (aPR: 1.83; 95% CI: 1.48-2.27) were associated with an increased prevalence of reporting barriers to accessing health services, whereas wage employment (aPR: 0.67; 95% CI: 0.49-0.90) was associated with decreased prevalence of reporting barriers to accessing health services. Overall, we found a high prevalence of psychological distress and interruptions in access to healthcare services 2 years into the pandemic across five sub-Saharan African countries. Increased effort and attention should be given to addressing the negative impacts of COVID-19 on psychological distress. An equitable and collaborative approach to new and existing preventive measures for COVID-19 is crucial to limit the consequences of COVID-19 on the health of adults in sub-Saharan Africa.

Department

Global Health

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