ArticleBMC health services research2026
Impacts of COVID-19 mobility-restricting policies and perceived COVID-19 risks on household unmet medical needs in Nigeria: a difference-in-differences analysis.
Article in BMC health services research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe coronavirus disease (COVID-19) pandemic and mobility-restricting policies (MRPs) have created substantial barriers to healthcare access globally. This study quantified the causal impact of government-imposed MRPs and perceived COVID-19 risk on household unmet medical needs in Nigeria, examining the differential effects for vulnerable populations.
methodsWe conducted difference-in-differences analyses using nationally representative household panel data from the pre-pandemic period (January-February 2019, n = 1,596 households) and the early pandemic period (April-August 2020). Unmet needs were measured as self-reported forgone medical care at the household level. We employed two approaches to disentangle voluntary from policy-driven restrictions: comparing states with total versus partial lockdown, and comparing states with below- versus above-median mobility reductions (Google Mobility data). We estimated COVID-19 risk effects across four state-level case burden categories during and after the lockdown.
resultsHouseholds in total lockdown states experienced 13.0% points (95%CI: 3.0–23.0) (doubling baseline rate) higher unmet needs compared to households in partial lockdown states. This converges with mobility approach showing 15.0% points (95%CI: 6.0–25.0) higher unmet needs among individuals with below-median mobility. During lockdown, the COVID-19 case burden had no significant differential impact. However, during the post-lockdown period (June-August 2020), households in Lagos (the epicentre, with more than 10,000 cases) experienced 24.0% points (95%CI: 2.0–46.0) higher unmet needs compared to low-risk states. Persons with disabilities faced disproportionate barriers during lockdown, with a 40.0% point (95% CI: 6.0–74.0) higher rate in high-risk states and a 74.0% point (95%CI: 22.0-126.0) higher rate in the epicentre. No differential impacts were observed for poverty or chronic disease status.
conclusionConsidering the detrimental effects of unmet medical needs, this study suggests that policymakers should evaluate the risks of COVID-19 in relation to the implementation of MRPs to protect households and vulnerable groups during future pandemics in Nigeria.
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