The socio-economic and health effects of COVID-19 among rural and urban-slum dwellers in Ghana: A mixed methods approach

Abstract

Background Vulnerable populations such as rural and urban-slum dwellers are more likely to suffer greatly from the deleterious effects of the novel Coronavirus disease 2019 (COVID-19). However, in Ghana, most COVID-19 mitigating packages are not focused on vulnerable populations. Methods Concurrent mixed methods design was used to examine the socio-economic and health effects of COVID-19 among rural and urban-slum dwellers in Ghana. Four hundred respondents were sampled for the quantitative arm of the study, while 46 In-depth Interviews (IDIs) were conducted with community members and government officials. Sixty-four community members participated in Focus Group Discussions (FGDs) and non-participant observation was carried out for three months. Quantitative data were analysed using frequencies, percentages, Pearson Chi2 and ordered logistic regression. Interviews were recorded using digital recorders and later transcribed. Transcribed data (IDIs, FGDs) and observation notes were uploaded onto a computer and transferred to qualitative software NVivo 12 to support thematic coding and analysis. Results Majority of the respondents confirmed the deleterious socio-economic and health effects of COVID-19 on jobs and prices of food. Other effects were fear of visiting a health facility even when unwell, depression and anxiety. Young people (18–32 years), males, urban-slum dwellers, married individuals, the employed and low-income earners (those who earn GHC10/$1.7 to GHC100/ $17), were more likely to suffer from the socio-economic and health effects of COVID-19. Urban-slum dwellers coped by relying on family and social networks for food and other basic necessities, while rural dwellers created locally appropriate washing aids to facilitate hand washing in the rural communities. Conclusion COVID-19 and the government’s mitigation measures had negative socio-economic and health effects on vulnerable communities. While vulnerable populations should be targeted for the government’s COVID-19 mitigating packages, special attention should be given to young people (18–32 years), males, urban-slum dwellers, married individuals and low-income earners. Communities should be encouraged to maintain coping strategies adopted even after COVID-19.

Promoting COVID-19 Vaccine Acceptance through Community Engagement: An Ethnographic Study in Ghana

“…Earlier studies in two other districts in Ghana equally revealed that misconceptions, myths, and lack of trust in the government's efort towards managing the pandemic contributed to poor attitudes towards COVID-19 prevention and management [35,36]. Other studies have noted that the problem of COVID-19 vaccine hesitancy is not limited to the Ghanaian population but to African populations [37,38].…”

Factors affecting hand hygiene practice during the COVID-19 pandemic in the Zimbabwean population: a qualitative study

“…As was indicated in some settings in this study, the household was supposed to have at least one tippy tap. A similar approach has also been noted in Ghana [ 22 , 31 ], and these tippy taps have been noted to improve hand washing. While this mitigatory measure is welcome, such vulnerable communities should be considered for the provision of long-term mitigatory measures, as the tippy tap does not carry much water and thus would require frequent refilling.…”

“…Those with these resources mentioned that hand hygiene was not a challenge, while the absence of these hand washing facilities, soap and/or sanitizer were cited as barriers to hand hygiene. These environmental determinants have also been noted as barriers to hand washing in Ghana among rural and urban slum dwellers [ 22 , 31 ], among slum dwellers in Kenya [ 32 ], young adult students in Canada [ 27 ] and in poor settlements in Accra and Johannesburg [ 33 ]. A previous study in Zimbabwe also identified a lack of hand hygiene facilities as one of the challenges driving SARS-CoV-2 transmission in the country [ 24 ].…”

Health care support systems for informal settlement rental housing during the COVID-19 season: landlord’s perspective

“…Options usually available to informal settlers, especially in Madina, Ghana, is to resort to self-medication and the services of lay health personnel. Similarly, Aberese-Ako et al (2022) also found that during the pandemic informal settlers were afraid to visit health facilities to seek health care because of the misapprehension that coughing, even without a COVID-19 test, might be credited to the COVID-19 disease. These resulted in increase in self-medication.…”