ArticleBMC health services research2022
Using Andersen's model of health care utilization to assess factors associated with COVID-19 testing among adults in nine low-and middle-income countries: an online survey.
Article in BMC health services research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 21 citations in OpenAlex.
- Determinants of Digital Health Resource Utilization Among Individuals With Self-Reported Bipolar Disorder in Germany-A Cross-Sectional Study Based on the Andersen Model.Bipolar disorders · 2026Article
- Household determinants of healthcare utilisation in three informal settlements in Freetown, Sierra Leone: a cross-sectional survey.BMJ open · 2026Article
- COVID-19 testing and mental health service utilization in Ontario: a population-based cohort study.International journal of public health · 2026Article
- National trends in the unmet healthcare needs among patients with hypertension or type 2 diabetes mellitus in Korea from 2009 to 2023.Scientific reports · 2025Article
- Modeling determinants of accessibility for healthcare services in rural and urban areas of Dodoma, Tanzania.BMC public health · 2025Article
- Zero-Dose Vaccination Among Children Aged 12-35 Months in Ethiopia.TheScientificWorldJournal · 2025Article
- "Resilience amidst challenges": Healthcare users' experiences of access and utilisation of primary healthcare services during the COVID-19 pandemic in southwestern Uganda.PLOS global public health · 2025Article
- A cross-sectional study of COVID-19 testing and disclosure hesitancy: The role of responsibility attribution in South Korea.PloS one · 2025Article
- Examining the referral of patients with elevated blood pressure to health resources in an under-resourced community in South Africa.BMC public health · 2024Article
- Implementation pilot study of community self-testing for COVID-19 among employees of manufacturing industries and their household members in 2022 to 2023.PLOS global public health · 2024Article
- Have immigrant children been left behind in COVID-19 testing rates? - A quantitative study in the Lisbon metropolitan area between march 2020 and may 2023.Frontiers in public health · 2024Article
- Impact of COVID-19 on health service utilisation in sub-Saharan Africa: protocol for a scoping review.BMJ open · 2023Article
- Effectiveness of chatbots on COVID vaccine confidence and acceptance in Thailand, Hong Kong, and Singapore.NPJ digital medicine · 2023Article
- Dynamics of factors associated with rates of COVID-19 cases and deaths in African countries.Globalization and health · 2023Article
- Community-based SARS-CoV-2 testing in low-income neighbourhoods in Rotterdam: Results from a pilot study.Journal of global health · 2022Article
- Retention in Community Health Screening among Taiwanese Adults: A 9-Year Prospective Cohort Study.International journal of environmental research and public health · 2022Article
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Authors and funding
15 authors at 13 institutions in 13 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThis study aimed to investigate, using Andersen's model of health care utilization, factors associated with COVID-19 testing among adults in nine low- and middle- income countries.
methodsIn between 10 December 2020 and 9 February 2021, an online survey was organized in nine low- and middle-income countries. In total 10,183 adults (median age 45 years, interquartile range 33-57 years, range 18-93 years), including 6470 from Brazil, 1738 Malaysia, 1124 Thailand, 230 Bangladesh, 219 DR Congo, 159 Benin, 107 Uganda, 81 Malawi and 55 from Mali participated in the study. COVID-19 testing/infection status was assessed by self-report.
resultsOf the 10,183 participants, 40.3% had ever tested for COVID-19, 7.3% tested positive, and 33.0% tested negative. In an adjusted logistic regression model, predisposing factors (residing in Brazil, postgraduate education), enabling/disabling factors (urban residence, higher perceived economic status, being a student or worker in the health care sector, and moderate or severe psychological distress), and need factors (having at least one chronic condition) increased the odds of COVID-19 testing. Among those who were tested, participants residing in Bangladesh, those who had moderate to severe psychological distress were positively associated with COVID-19 positive diagnosis. Participants who are residing in Malaysia and Thailand, and those who had higher education were negatively associated with a COVID-19 positive diagnosis. Considering all participants, higher perceived economic status, being a student or worker in the health sector, and moderate or severe psychological distress were positively associated with a COVID-19 positive diagnosis, and residing in Malaysia, Thailand or five African countries was negatively associated with a COVID-19 positive diagnosis.
conclusionA high rate of COVID-19 testing among adults was reported in nine low-and middle-income countries. However, access to testing needs to be increased in Africa. Moreover, COVID-19 testing programmes need to target persons of lower economic status and education level who are less tested but most at risk for COVID-19 infection.
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