Barriers, facilitators, and accessibility to health services among people of concern before and during the COVID-19 pandemic in Nigeria

Abstract

Unequal access to health services has long been a challenge for the People of Concern (PoC) before the COVID-19 pandemic. Still, the emergence of the COVID-19 pandemic widened existing inequalities in access to health services. Using a multivariate binary logistic regression model, we analyzed 2020 United Nations High Commissioner for Refugees (UNHCR) data on forcibly displaced populations to examine barriers, facilitators, and access to health services before and during COVID-19 among PoC in Nigeria. Access to health services was higher among women (82.63%; 74.57%) than among men (81.99%; 71.34%) before and during the COVID-19 pandemic, respectively. The adjusted odds ratios indicated that facilitators of access to health services were the same before and during the pandemic. Being a Cameroonian (AOR = 2.33; 95% CI [1.14–4.76]), fear of contracting COVID-19 (AOR = 1.59; 95% CI [1.37–1.85]), and being a host (AOR = 2.13; 95% CI [1.06–4.27]) increased the likelihood of accessing health services only during the pandemic. Being a man (AOR = 0.74; 95% CI [0.63–0.86]), a refugee returnee (AOR = 0.31; 95% CI [0.11–0.83]), and lack of competent personnel (AOR = 0.74; 95% CI [0.58–0.95]) reduced the likelihood of accessing health services only before the pandemic. The study shows that policies that empower PoC must be a significant focus to achieve optimum access to healthcare services, especially during outbreaks and other health emergencies.