Quantifying the Impact of Social Determinants on Preventive Healthcare Uptake in Sub-Saharan Africa

Preventive healthcare, which includes immunisations, screenings, antenatal care, and health checks, offers a proactive approach to reducing disease burdens and enhancing population wellness, especially in resource-limited settings like Sub-Saharan Africa (SSA). However, uptake remains uneven due to underlying social determinants of health (SDOH) such as wealth, education, and occupation. This study aims to quantify the impact of these determinants on preventive healthcare utilisation in SSA to guide evidence-based and equitable health strategies. A cross- sectional design was used, leveraging pooled secondary data from the Demographic and Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS) conducted between 2015 and 2022 across 12 SSA countries. Key social determinants—wealth index, education level, and occupational status—were analysed alongside the uptake of preventive services, including immunisation, antenatal visits, cancer screening, HIV testing, and blood pressure checks. Multivariate logistic regression was performed to derive adjusted odds ratios (AORs), controlling for demographic confounders. The results show a strong positive link between higher socioeconomic status and greater use of preventive services. For instance, full childhood immunisation rates stood at 87. 5% in the highest wealth quintile compared to 52. 1% in the lowest (AOR = 2. 68, p < 0. 001). Similarly, women with tertiary education had a 90. 2% antenatal care completion rate versus 60. 7% among uneducated peers (AOR = 3. 12, p < 0. 001). Adults who were formally employed were significantly more likely to have blood pressure checks (68. 1% vs. 39. 2%) and HIV testing (61. 7% vs. 35. 5%) than their counterparts in informal or agricultural work. The findings confirm that wealth, education, and occupation significantly influence access to preventive healthcare in SSA. Wealthier, educated, and formally employed individuals benefit more from preventive interventions due to better access to health information, stable income, and employment benefits. Conversely, informal workers and uneducated individuals face logistical, informational, and financial barriers that hinder their health- seeking behaviours. These disparities reflect deeper structural inequalities that require policy reforms and targeted health interventions. Social determinants of health crucially shape the landscape of preventive care in Sub-Saharan Africa. Without deliberate policy action, the most vulnerable populations—those who are poor, uneducated, or informally employed will remain underserved. Addressing this gap necessitates equity- focused reforms in health systems, investments in education and employment, and cross- sectoral collaboration. Ensuring universal and inclusive access to preventive services is essential not only for public health but also as a matter of social justice.