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

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.

KEYWORDS:

• Ageing
• formal healthcare utilization
• Ghana
• health insurance scheme
• older adults with low income

Key Points

• About 13% of older adults with low income and health insurance subscription enrolled in the LEAP program in Ghana do not utilize formal healthcare.

• Older adults with family support were more likely to utilize formal healthcare services.

• Self-perceived physical activeness was associated with formal healthcare utilization.

• Having non-communicable diseases was associated with formal healthcare utilization.

• Policies and programs should be developed to promote formal healthcare utilization among older adults with low income and health insurance subscription.

Disclosure statement

No potential conflict of interest was reported by the authors.

Ethics Approval and Consent to Participate

The Committee on Human Research Publication and Ethics (CHRPE), School of Medical Sciences, Kwame Nkrumah University of Science and Technology and Komfo Anokye Teaching Hospital, Kumasi, Ghana provided ethical clearance for the study (Ref: CHRPE/AP/311/18). Informed written and verbal consents were obtained from the study participants before data were collected. The procedures and protocol of the study were conducted according to the tenant of declaration of Helsinki. The study participants were also assured of strict confidentiality and anonymity of the data they provided.

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.