COVID-19 And Presenteeism: Longitudinal Evidence From Healthcare Workers In Greater Accra, Ghana

Abstract

Introduction: We investigated the impact of COVID-19 on presenteeism among healthcare workers (HCWs) in the Greater Accra Region of Ghana. Methods: This longitudinal follow-up study employed a census approach to include 756 HCWs, comprising 252 COVID-19–exposed and 504 unexposed participants. Data were collected at baseline, month 3, and month 6. Statistical analyses were conducted using Stata LP version 15. Pearson’s chi-square tests were used to assess differences in presenteeism between exposure groups at each time point. Variables showing significant associations were included in a multivariable generalized linear model with a proportional odds specification to estimate adjusted proportional odds ratios with 95% confidence intervals. Statistical significance was set at α = 0.05. Results: High presenteeism was consistently observed over the six-month period, peaking at 91.7% at month 3. Presenteeism rates were significantly higher among COVID-19–exposed HCWs at all time points (p < 0.005). Factors associated with increased presenteeism included having five or more dependents, holding part-time jobs, and working as a nurse or laboratory scientist, whereas HCWs with 5–9 years of experience had lower odds. Moderate to severe depression and anxiety were associated with reduced odds of high presenteeism, although severe anxiety at baseline was linked to increased odds. Overall, presenteeism declined over time. Conclusion: Presenteeism remains high among HCWs, particularly those experiencing psychological distress. Targeted interventions, including improved working conditions, mental health support, adequate personal protective equipment, and workforce strengthening, are essential to safeguard HCW well-being and health system resilience.