Predictive Factors for Health Service Utilization in Rural Ghana: A Community-Based Analytical Study

Abstract: Achieving universal healthcare coverage in rural Ghana continues to be challenging despite considerable investments in the health system. This study predicted factors influencing health service utilization among residents in rural Ghana, to guide evidence-based strategies aimed at enhancing universal coverage. A community-based analytical study was conducted involving 1,738 adults. Participants were selected using multistage sampling method and a structured questionnaire based on the Andersen Behavioral Model was adopted. Chi-square tests, binary logistic regression, and multiple linear regression analyses were conducted using Stata 12.0, with statistical significance set at p<0.05. Results indicated that age, educational level, marital status, and monthly income were significant predictors of health service utilization. Also, rural resident with tertiary education were 1.99 times more likely to utilize health services than those with no formal education. Rural dwellers earning above GH¢2,000 monthly were 3.21 times more likely to utilize services than those earning below GH¢500. Unmarried individuals were 0.09 times less likely to utilize healthcare services compared to married ones. Health facility factors; distance, cost of treatment, perceived quality of care, and waiting time, explained 69.5% of the variation in health service utilization, where cost of treatment had the strongest influence. Health provider factors, including worker’s attitude, job knowledge, work experience, and in-service training were significantly associated with healthcare utilization. Several factors influence health service utilization among rural population. To improve utilization, interventions should incorporate multifaceted factors to tackle socioeconomic barriers, financial difficulties, geographic constraints and digital health technologies, enhancing residents’ competency through education and financial empowerment.