Caregiving dynamics and labor market outcomes of unorganized caregivers of older adults in Ghana

Caregiving dynamics and labor market outcomes of unorganized caregivers of older adults in Ghana | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Caregiving dynamics and labor market outcomes of unorganized caregivers of older adults in Ghana Daniel Offei, Ulrika Enemark, Robert Darko Osei, Razak M. Gyasi, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5818830/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 01 Sep, 2025 Read the published version in Journal of Health, Population and Nutrition → Version 1 posted 22 You are reading this latest preprint version Abstract Background Unorganized caregivers increasingly face significant challenges that impact their participation in the labor market, particularly in low- and middle-income countries. This paper explores the effects of both care intensity and the subjective caregiving burden on the labor force participation and work hours of these unorganized caregivers. Method We used data from a sample of 1,806 unorganized caregivers in Ghana who provide care to older adults aged 60 and above. High-intensive caregivers were classified as those providing 20 hours of caregiving per week, while the caregiving burden was measured using the short version of the Zarit Burden Interview score. The results were based on the average marginal effect from a logistic regression model. Results The results showed that both high-intensity and high-burden caregiving have notable effects on labor force participation and the work hours of unorganized caregivers. High-intensive caregivers were associated with an approximately 12% increase in the probability of reducing work hours. Also, high-burden caregivers were found to be associated with a 7% increase in the probability of being self-employed. The combined effect of high-intensity and high-burden caregiving was found to amplify the labor market challenges, particularly in reducing work hours and limiting the ability to maintain stable employment. Conclusion These findings highlight the significant impact of unorganized caregiving on labor market outcomes, particularly for those providing intensive and high-burden care. Policymakers should consider these effects when designing support systems for caregivers to mitigate the negative impact on employment and income stability.​ Care intensity caregiving burden labor market outcomes older adults Ghana. Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 01 Sep, 2025 Read the published version in Journal of Health, Population and Nutrition → Version 1 posted Editorial decision: Revision requested 13 May, 2025 Reviews received at journal 13 May, 2025 Reviews received at journal 11 May, 2025 Reviews received at journal 30 Apr, 2025 Reviewers agreed at journal 29 Apr, 2025 Reviewers agreed at journal 27 Apr, 2025 Reviewers agreed at journal 25 Apr, 2025 Reviewers agreed at journal 24 Apr, 2025 Reviewers agreed at journal 22 Apr, 2025 Reviewers agreed at journal 22 Apr, 2025 Reviewers agreed at journal 22 Apr, 2025 Reviewers agreed at journal 22 Apr, 2025 Reviewers agreed at journal 22 Apr, 2025 Reviewers agreed at journal 21 Apr, 2025 Reviewers agreed at journal 21 Apr, 2025 Reviewers agreed at journal 21 Apr, 2025 Reviewers agreed at journal 20 Apr, 2025 Reviewers agreed at journal 20 Apr, 2025 Reviewers agreed at journal 05 Apr, 2025 Reviewers invited by journal 03 Apr, 2025 Submission checks completed at journal 20 Mar, 2025 First submitted to journal 17 Mar, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5818830","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":435477593,"identity":"f76ff88f-0c2f-445c-9bd1-4f29ad3ef1ac","order_by":0,"name":"Daniel Offei","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA6ElEQVRIie2QsQrCMBCGEw6uS9C1RcVXKHSvr9LQVVyEgnQQKZyjj+BbZC8F3ZwFB1t9gg5C3UyLi0tbN8F8w0GO/yN3x5jB8ItAmrMAGUMGm1y/xaBTwdB9KzxxawV7KayJcbKbRpcxROB5HvmLgbWh1WPuj/WExe3cojgE4AancIkipctEhXow9Lx5i+JedwdbEkjS9eIo0IrAUatyAKuStJY0LWjpqHUvBZmkTP/CiZcq61bqXezgdJQkZDLi6igQOnapL1ZWUSz32ywtnyqeDa2kuLcpH4Boat94Da++SRsMBsPf8AIk1kIVK1AZbwAAAABJRU5ErkJggg==","orcid":"","institution":"University of Ghana","correspondingAuthor":true,"prefix":"","firstName":"Daniel","middleName":"","lastName":"Offei","suffix":""},{"id":435477594,"identity":"ca2b9e09-b0ab-435d-a829-804abe49312d","order_by":1,"name":"Ulrika Enemark","email":"","orcid":"","institution":"Aarhus University","correspondingAuthor":false,"prefix":"","firstName":"Ulrika","middleName":"","lastName":"Enemark","suffix":""},{"id":435477595,"identity":"08d056aa-fb1e-4348-821e-660d33f69b8a","order_by":2,"name":"Robert Darko Osei","email":"","orcid":"","institution":"University of Ghana","correspondingAuthor":false,"prefix":"","firstName":"Robert","middleName":"Darko","lastName":"Osei","suffix":""},{"id":435477596,"identity":"a0ea3d8c-77b8-426b-a501-1a625b6a6003","order_by":3,"name":"Razak M. Gyasi","email":"","orcid":"","institution":"African Population and Health Research Center","correspondingAuthor":false,"prefix":"","firstName":"Razak","middleName":"M.","lastName":"Gyasi","suffix":""},{"id":435477597,"identity":"d1426508-e39e-4ad0-9172-772a83c7373f","order_by":4,"name":"Charles Godfred Ackah","email":"","orcid":"","institution":"University of Ghana","correspondingAuthor":false,"prefix":"","firstName":"Charles","middleName":"Godfred","lastName":"Ackah","suffix":""}],"badges":[],"createdAt":"2025-01-13 09:53:37","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5818830/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5818830/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s41043-025-00997-x","type":"published","date":"2025-09-02T00:00:00+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":90521348,"identity":"f243177f-7a1e-45dd-8318-50cf9cccb2c5","added_by":"auto","created_at":"2025-09-03 15:41:23","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":474546,"visible":true,"origin":"","legend":"","description":"","filename":"OffeiDPaperforpublicationinBMCJournalRevisedVersion2.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5818830/v1_covered_c525ff2d-ea52-4db0-a4e3-b9fbd48612bf.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Caregiving dynamics and labor market outcomes of unorganized caregivers of older adults in Ghana","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"journal-of-health-population-and-nutrition","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"johp","sideBox":"Learn more about [Journal of Health, Population and Nutrition](http://jhpn.biomedcentral.com/)","snPcode":"41043","submissionUrl":"https://submission.nature.com/new-submission/41043/3","title":"Journal of Health, Population and Nutrition","twitterHandle":"@BioMedCentral","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Care intensity, caregiving burden, labor market outcomes, older adults, Ghana. ","lastPublishedDoi":"10.21203/rs.3.rs-5818830/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5818830/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cb\u003eBackground\u003c/b\u003e\u003c/p\u003e \u003cp\u003eUnorganized caregivers increasingly face significant challenges that impact their participation in the labor market, particularly in low- and middle-income countries. This paper explores the effects of both care intensity and the subjective caregiving burden on the labor force participation and work hours of these unorganized caregivers.\u003c/p\u003e\u003cp\u003e\u003cb\u003eMethod\u003c/b\u003e\u003c/p\u003e \u003cp\u003e We used data from a sample of 1,806 unorganized caregivers in Ghana who provide care to older adults aged 60 and above. High-intensive caregivers were classified as those providing 20 hours of caregiving per week, while the caregiving burden was measured using the short version of the Zarit Burden Interview score. The results were based on the average marginal effect from a logistic regression model.\u003c/p\u003e\u003cp\u003e\u003cb\u003eResults\u003c/b\u003e\u003c/p\u003e \u003cp\u003eThe results showed that both high-intensity and high-burden caregiving have notable effects on labor force participation and the work hours of unorganized caregivers. High-intensive caregivers were associated with an approximately 12% increase in the probability of reducing work hours. Also, high-burden caregivers were found to be associated with a 7% increase in the probability of being self-employed. The combined effect of high-intensity and high-burden caregiving was found to amplify the labor market challenges, particularly in reducing work hours and limiting the ability to maintain stable employment.\u003c/p\u003e\u003cp\u003e\u003cb\u003eConclusion\u003c/b\u003e\u003c/p\u003e \u003cp\u003eThese findings highlight the significant impact of unorganized caregiving on labor market outcomes, particularly for those providing intensive and high-burden care. Policymakers should consider these effects when designing support systems for caregivers to mitigate the negative impact on employment and income stability.​\u003c/p\u003e","manuscriptTitle":"Caregiving dynamics and labor market outcomes of unorganized caregivers of older adults in Ghana","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-04-03 05:34:20","doi":"10.21203/rs.3.rs-5818830/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-05-13T09:30:19+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-05-13T09:09:58+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-05-11T18:38:14+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-04-30T16:20:00+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"41973628959542708982381075043801511890","date":"2025-04-29T12:53:54+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"173330364461654331195110311439704965215","date":"2025-04-27T14:43:05+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"102131251290253292062055097939911320957","date":"2025-04-25T06:33:26+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"3261691443957706922684420376651126933","date":"2025-04-24T10:38:13+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"148527934304348349438256870082784213190","date":"2025-04-22T18:34:27+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"43899235379961389790486138318476673993","date":"2025-04-22T18:10:29+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"129252148277541132450415869674751911129","date":"2025-04-22T12:46:27+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"287952419437440768169351117270593838680","date":"2025-04-22T06:37:04+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"155003104578669340321317551983865795527","date":"2025-04-22T04:01:56+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"61264503247195811288237015947184670852","date":"2025-04-21T14:04:03+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"281718273173215062566631482687953567420","date":"2025-04-21T11:01:44+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"320291057470965114442174380456425834523","date":"2025-04-21T06:09:13+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"111833431543401398489065903961399902077","date":"2025-04-20T09:54:42+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"64300992702117176203555504756995996992","date":"2025-04-20T07:54:27+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"231321951648876882192925158428331150290","date":"2025-04-05T17:56:28+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-04-03T05:25:03+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-03-20T05:04:07+00:00","index":"","fulltext":""},{"type":"submitted","content":"Journal of Health, Population and Nutrition","date":"2025-03-17T17:42:24+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"journal-of-health-population-and-nutrition","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"johp","sideBox":"Learn more about [Journal of Health, Population and Nutrition](http://jhpn.biomedcentral.com/)","snPcode":"41043","submissionUrl":"https://submission.nature.com/new-submission/41043/3","title":"Journal of Health, Population and Nutrition","twitterHandle":"@BioMedCentral","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"71a64784-ea39-4342-a5d3-da35621e044a","owner":[],"postedDate":"April 3rd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-09-03T15:41:17+00:00","versionOfRecord":{"articleIdentity":"rs-5818830","link":"https://doi.org/10.1186/s41043-025-00997-x","journal":{"identity":"journal-of-health-population-and-nutrition","isVorOnly":false,"title":"Journal of Health, Population and Nutrition"},"publishedOn":"2025-09-02 00:00:00","publishedOnDateReadable":"September 2nd, 2025"},"versionCreatedAt":"2025-04-03 05:34:20","video":"","vorDoi":"10.1186/s41043-025-00997-x","vorDoiUrl":"https://doi.org/10.1186/s41043-025-00997-x","workflowStages":[]},"version":"v1","identity":"rs-5818830","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5818830","identity":"rs-5818830","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}