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CC BY-NC-ND V4.0, Open Access
Journal article
Impacts of COVID-19 mobility-restricting policies and perceived COVID-19 risks on household unmet medical needs in Nigeria: a difference-in-differences analysis
BMC health services research, In Press
2026
PMID: 41580759
Abstract
Background
The 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.
Methods
We 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.
Results
Households 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.
Conclusion
Considering 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.
Details
- Title
- Impacts of COVID-19 mobility-restricting policies and perceived COVID-19 risks on household unmet medical needs in Nigeria: a difference-in-differences analysis
- Authors/Creators
- Adelakun Odunyemi (Author) - Murdoch UniversityHamid R. Sohrabi (Author) - Murdoch UniversityKhurshid Alam (Author) - Murdoch University
- Publication Details
- BMC health services research, In Press
- Publisher
- Springer Nature
- Identifiers
- 991005855088107891
- Copyright
- © The Author(s) 2026.
- Murdoch Affiliation
- School of Psychology; Murdoch Business School; Ngangk Yira Institute for Change; Centre for Healthy Ageing; Health Futures Institute; Personalised Medicine Centre
- Language
- English
- Resource Type
- Journal article
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