Health insurance coverage and timely antenatal care attendance in sub-Saharan Africa

BMC Health Services Research

Abdul-Aziz Seidu¹  Richard Gyan Aboagye²  Hubert Amu³  Joshua Okyere⁴  Betregiorgis Zegeye⁵  Sanni Yaya⁶  Bright Opoku Ahinkorah⁷ 

[1] Centre for Gender and Advocacy, Takoradi Technical University, Takoradi, Ghana;Department of Estate Management, Takoradi Technical University, Takoradi, Ghana;College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia;Department of Family and Community Health, School of Public Health, University of Health and Allied Sciences, Ho, Ghana;Department of Population and Behavioural Sciences, School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana;Department of Population and Health, University of Cape Coast, Cape Coast, Ghana;HaSET Maternal and Child Health Research Program, Shewarobit Field Office, Shewarobit, Ethiopia;School of International Development and Global Studies, University of Ottawa, Ottawa, Canada;The George Institute for Global Health, Imperial College London, London, United Kingdom;School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia;

关键词: National Health Insurance;    Timely ANC;    Pregnant women;    Sub-Saharan Africa;   

DOI  :  10.1186/s12913-022-07601-6

来源: Springer

【 摘 要 】

IntroductionOut-of-pocket payments for healthcare remain a significant health financing challenge in sub-Saharan Africa (SSA), preventing women from using maternal health services. There is a paucity of empirical literature on the influence of health insurance coverage on the timeliness of antenatal care (ANC) attendance in low- and middle-income countries. In this study, we examined the association between health insurance coverage and timely ANC attendance among pregnant women in SSA.MethodsSecondary data from Demographic and Health Surveys conducted between 2015 and 2020 in sixteen (16) sub-Saharan African countries with 113,918 women aged 15-49 years were included in the analysis. The outcome variable was the timing of antenatal care (ANC). A multilevel binary logistic regression analysis was carried out to determine the association between health insurance coverage and timely ANC.ResultsThe overall coverage of health insurance and timely antenatal attendance among pregnant women in SSA were 4.4% and 39.0% respectively. At the country level, the highest coverage of health insurance was found in Burundi (24.3%) and the lowest was in Benin (0.9%). For timely ANC attendance, the highest prevalence was in Liberia (72.4%) and the lowest was in Nigeria (24.2%). The results in the model showed that women who were covered by health insurance were more likely to have timely ANC attendance compared to those who were not covered by health insurance (aOR = 1.21, 95% CI = 1.11-1.31).ConclusionOur findings show that that being covered under health insurance is associated with higher likelihood of seeking timely ANC attendance. To accelerate progress towards achievement of the Sustainable Development Goal targets by the year 2030, we recommend that governments and health insurance authorities across the sub-Saharan African countries actively implement health insurance policies as well as roll out health educational programmes that facilitate and ensure increased coverage of health insurance.

【 授权许可】

CC BY