Beyond COVID-19: Behavioral Drivers of Pandemic Prevention in Ghana’s Informal Urban Settlements

Richmond Amponsah; Marie Vaganay Miller; Aaron Lawson; Nigel McConnell

doi:10.1007/s11524-026-01106-x

Beyond COVID-19: Behavioral Drivers of Pandemic Prevention in Ghana’s Informal Urban Settlements

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Abstract

The COVID-19 pandemic highlighted significant disparities in the uptake of precautionary health behaviors, particularly in informal settlements in sub-Saharan Africa (SSA), where access to essential infrastructure and socio-economic opportunities are limited. This study applied the information-motivation-behavioral (IMB) skills model of pandemic risk and prevention to explore the pathways through which COVID-19 information, personal and social motivation, and behavioral skills influenced the uptake of prevention behaviors in three informal settlements in Ghana. A survey of 496 participants was conducted and analyzed using structural equation modeling (SEM). Findings reveal a significant knowledge gap, with only 30.6% of participants answering all COVID-19 information questions accurately. Both personal (β = 0.209, p = 0.005) and social motivation (β = 0.178, p = 0.018) exhibited a direct significant relationship with preventive behaviors. While no direct effect was found between information and prevention behavior, behavioral skills fully mediated this relationship. Though focused on COVID-19, the findings have broader implications for strengthening pandemic/epidemic preparedness in informal settlements. Policy interventions should prioritize tailored health risk communication, motivation enhancement, and practical skills-building to empower vulnerable populations not just for current needs but to effectively respond to future health crises.

Original language	English
Number of pages	14
Journal	Journal of Urban Health
Early online date	1 Jul 2026
DOIs	https://doi.org/10.1007/s11524-026-01106-x
Publication status	Published (in print/issue) - 1 Jul 2026

Bibliographical note

Publisher Copyright:
© The Author(s) 2026.

Data Availability Statement

The data supporting the findings of this study are not publicly available due to ethical and privacy considerations involving human participants from vulnerable informal settlements. However, datasets may be made available upon reasonable request to the corresponding author, subject to approval by the relevant ethics committee and in compliance with data protection regulations.

Funding

This study received no external funding. The study forms part of the first author's (R.A.) fully funded doctoral programme at Ulster University (2023–2026). Fieldwork was supported by an internal research grant from the Belfast School of Architecture and the Built Environment, Ulster University, UK.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being
SDG 10 Reduced Inequalities
SDG 11 Sustainable Cities and Communities

Keywords

COVID-19 pandemic
Prevention health behavior
Informal settlement
Sub-Saharan Africa
Structural equation modeling

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s11524-026-01106-x (2)Final published version, 739 KBLicence: CC BY

Cite this

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title = "Beyond COVID-19: Behavioral Drivers of Pandemic Prevention in Ghana{\textquoteright}s Informal Urban Settlements",

abstract = "The COVID-19 pandemic highlighted significant disparities in the uptake of precautionary health behaviors, particularly in informal settlements in sub-Saharan Africa (SSA), where access to essential infrastructure and socio-economic opportunities are limited. This study applied the information-motivation-behavioral (IMB) skills model of pandemic risk and prevention to explore the pathways through which COVID-19 information, personal and social motivation, and behavioral skills influenced the uptake of prevention behaviors in three informal settlements in Ghana. A survey of 496 participants was conducted and analyzed using structural equation modeling (SEM). Findings reveal a significant knowledge gap, with only 30.6\% of participants answering all COVID-19 information questions accurately. Both personal (β = 0.209, p = 0.005) and social motivation (β = 0.178, p = 0.018) exhibited a direct significant relationship with preventive behaviors. While no direct effect was found between information and prevention behavior, behavioral skills fully mediated this relationship. Though focused on COVID-19, the findings have broader implications for strengthening pandemic/epidemic preparedness in informal settlements. Policy interventions should prioritize tailored health risk communication, motivation enhancement, and practical skills-building to empower vulnerable populations not just for current needs but to effectively respond to future health crises.",

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ER -

Beyond COVID-19: Behavioral Drivers of Pandemic Prevention in Ghana’s Informal Urban Settlements

Abstract

Bibliographical note

Data Availability Statement

Funding

UN SDGs

Keywords

Access to Document

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