Access to Healthcare Services among Youth Enrolled in Post School Training and Education (PSET) during the First Wave of COVID-19 Pandemic in South Africa

Abstract

Background: The global impact of the COVID-19 pandemic affected healthcare access, driven by demographic, social, and environmental factors. The study's rationale is to investigate the access of young people enrolled in higher institutions to healthcare services and determine the most frequently used communication (online, telephone or face-to-face) platforms for health and social support services during the first COVID-19 wave in South Africa. Methods: A secondary data analysis was conducted on a cross-sectional online survey conducted in 2020. Descriptive statistics were used to characterize healthcare access by socio-demographic, substance use and COVID-19-related factors. A multivariable forward stepwise logistic regression analysis was conducted to determine factors associated with young people’s access to healthcare services during the COVID-19 pandemic. Results: Among 4 404 participants, 71% accessed healthcare services. Youth aged 25-29 years (AOR=1.49, 95% CI [1.18-187]), White (AOR=2.78, 95% CI [1.79-4.32]) and Indian/Asian (AOR=2.04, 95% CI [1.19-3.54]) students were more likely to access services. Low COVID-19 risk perceptions were associated with increased access to healthcare services (AOR=1.23, 95% CI [0.96-1.56]). Those residing in informal settlements (AOR=0.60, 95% CI [0.38–0.95]), unaware of parental whereabouts (AOR=0.49, 95% CI [0.29-0.83]), and using recreational drugs (AOR=0.50, 95% CI [0.29-0.87]) had lower odds of accessing healthcare services. Awareness of COVID-19 transmission modes and loss of social contact with family or friends were also associated with reduced access to healthcare services. Conclusion: The COVID-19 pandemic exacerbated existing healthcare access disparities among youth. Targeted efforts, especially for Black Africans in informal settlements, are needed including youth-friendly services; telemedicine integration; and referral systems to local clinics.