Evidence map›Paper›PMID 41736053›Full record

ArticleBMC health services research2026

Quantifying inequality in the utilization of healthcare services provided by community-based health planning and services and its correlates in selected urban poor communities in Ghana: an analytic cross-sectional study, 2023.

Duah Dwomoh, Genevieve Cecilia Aryeetey, Kofi Agyabeng, Ada Nwameme, Lauren Wallace, Irene Agyepong, Justice Nonvignon, Selase Adjoa Odopey, Delali Kumapley, Ivy Akushika Agbenu and 5 more

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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. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

15 authors.

Duah DwomohDepartment of Biostatistics, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana. duahdwomoh@ug.edu.gh.
Genevieve Cecilia AryeeteyDepartment of Health Policy Planning and Management, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana.
Kofi AgyabengDepartment of Biostatistics, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana.
Ada NwamemeDepartment of Social and Behavioural Sciences, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana.
Lauren WallaceDepartment of Health Policy Planning and Management, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana.
Irene AgyepongPublic Health Faculty, Ghana College of Physicians and Surgeons, Accra, Ghana.
Justice NonvignonDepartment of Health Policy Planning and Management, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana.
Selase Adjoa OdopeyDepartment of Health Policy Planning and Management, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana.
Delali KumapleyDepartment of Health Policy Planning and Management, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana.
Ivy Akushika AgbenuDepartment of Health Policy Planning and Management, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana.
Bryony DawkinsLeeds Institute of Health Sciences, Nuffield Centre for International Health and Development, University of Leeds, Leeds, UK.
Joseph HicksLeeds Institute of Health Sciences, Nuffield Centre for International Health and Development, University of Leeds, Leeds, UK.
Bassey EbensoLeeds Institute of Health Sciences, Nuffield Centre for International Health and Development, University of Leeds, Leeds, UK.
Tim EnsorLeeds Institute of Health Sciences, Nuffield Centre for International Health and Development, University of Leeds, Leeds, UK.
Helen ElseyDepartment of Health Sciences, University of York, York, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCommunity-based Health Planning and Services (CHPS) was initially designed to address the healthcare needs of Ghana’s rural communities. However, with urban population growth and the subsequent healthcare demands of the urban poor, the CHPS policy was extended to urban areas. There is a significant gap in our understanding of the wealth-related disparities, correlates, and utilization levels of healthcare services under the urban CHPS. This study is a pioneering effort to fill this gap, aiming to quantify the utilization level, identify correlates, and measure wealth-related inequality in healthcare services provided by the CHPS in poor urban settings.

methodThe survey was conducted in four poor urban communities in the Greater Accra Region of Ghana using a quantitative analytic cross-sectional survey design with multistage cluster sampling, ensuring a representative sample of 3543 respondents (97.9% response rate) in the 2070 households. We used the Erreygers and Wagstaff normalized concentration indices with cluster-robust standard errors to estimate the level of inequalities in service utilization. A negative binomial regression model with a delta-based cluster robust standard error was used to identify correlates of service utilization.

resultsApproximately 25.1% [95% CI: 23.2, 27.1] of respondents in the four urban-poor communities utilized healthcare services provided by community health officers (CHOs) via the urban CHPS concept. The Erreygers normalized concentration index (CI) of 0.129 (p = 0.026) showed that the utilization of healthcare services through the urban CHPS concept is significantly more concentrated among the rich or better-off sample households than among the poor households. The utilization of healthcare services provided by CHOs was 17.5% [95% CI: 14.01, 20.94; p<0.001] greater among females than males and 12.0% [95% CI: 6.72, 17.21; p<0.001] greater among rich individuals relative to poor individuals. The utilization of healthcare services was 13.3% [95% CI: 8.53, 18.02; p<0.001] higher among persons living in slum households than those living in non-slum households.

conclusionHealthcare service utilization remains low, and disparities exist between the rich and the poor. These findings underscore the need to implement comprehensive, integrated targeted interventions with key stakeholder engagement to increase service utilization and address disparities in healthcare service utilization in poor urban settings.

Indexed as

Community Health PlanningHealthcare DisparitiesPatient Acceptance of Health CareUrban PopulationAdultCross-Sectional StudiesFemaleGhanaHealth Services AccessibilityHumansMaleMiddle AgedPovertyPoverty AreasSocioeconomic Disparities in HealthSocioeconomic FactorsCommunity-based health planning and servicesHealth service utilizationInequalityUrban healthUrban poor

Identifiers

PMID41736053
PMCPMC13036938

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.