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

Aboagye, RG; Okyere, J; Ahinkorah, BO; Seidu, A-A; Zegeye, B; Amu, H; Yaya, S

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

Aboagye, RG Okyere, J Ahinkorah, BO Seidu, A-A Zegeye, B Amu, H Yaya, S

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Publisher:: BioMed Central
Publication Type:: Journal Article
Citation:: BMC Health Services Research, 2022, 22, (1), pp. 1-12
Issue Date:: 2022-02-11

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Field	Value	Language
dc.contributor.author	Aboagye, RG
dc.contributor.author	Okyere, J
dc.contributor.author	Ahinkorah, BO
dc.contributor.author	Seidu, A-A
dc.contributor.author	Zegeye, B
dc.contributor.author	Amu, H
dc.contributor.author	Yaya, S
dc.date.accessioned	2022-11-09T03:59:23Z
dc.date.available	2022-02-04
dc.date.available	2022-11-09T03:59:23Z
dc.date.issued	2022-02-11
dc.identifier.citation	BMC Health Services Research, 2022, 22, (1), pp. 1-12
dc.identifier.issn	1472-6963
dc.identifier.issn	1472-6963
dc.identifier.uri	http://hdl.handle.net/10453/163366
dc.description.abstract	INTRODUCTION: Out-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. METHODS: Secondary 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. RESULTS: The 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). CONCLUSION: Our 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.
dc.format	Electronic
dc.language	eng
dc.publisher	BioMed Central
dc.relation.ispartof	BMC Health Services Research
dc.relation.isbasedon	10.1186/s12913-022-07601-6
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	0807 Library and Information Studies, 1110 Nursing, 1117 Public Health and Health Services
dc.subject.classification	Health Policy & Services
dc.subject.mesh	Adolescent
dc.subject.mesh	Adult
dc.subject.mesh	Africa South of the Sahara
dc.subject.mesh	Female
dc.subject.mesh	Humans
dc.subject.mesh	Insurance Coverage
dc.subject.mesh	Maternal Health Services
dc.subject.mesh	Middle Aged
dc.subject.mesh	Pregnancy
dc.subject.mesh	Pregnant Women
dc.subject.mesh	Prenatal Care
dc.subject.mesh	Young Adult
dc.subject.mesh	Adolescent
dc.subject.mesh	Adult
dc.subject.mesh	Africa South of the Sahara
dc.subject.mesh	Female
dc.subject.mesh	Humans
dc.subject.mesh	Insurance Coverage
dc.subject.mesh	Maternal Health Services
dc.subject.mesh	Middle Aged
dc.subject.mesh	Pregnancy
dc.subject.mesh	Pregnant Women
dc.subject.mesh	Prenatal Care
dc.subject.mesh	Young Adult
dc.subject.mesh	Humans
dc.subject.mesh	Prenatal Care
dc.subject.mesh	Pregnancy
dc.subject.mesh	Adolescent
dc.subject.mesh	Adult
dc.subject.mesh	Middle Aged
dc.subject.mesh	Pregnant Women
dc.subject.mesh	Maternal Health Services
dc.subject.mesh	Insurance Coverage
dc.subject.mesh	Africa South of the Sahara
dc.subject.mesh	Female
dc.subject.mesh	Young Adult
dc.title	Health insurance coverage and timely antenatal care attendance in sub-Saharan Africa.
dc.type	Journal Article
utslib.citation.volume	22
utslib.location.activity	England
utslib.for	0807 Library and Information Studies
utslib.for	1110 Nursing
utslib.for	1117 Public Health and Health Services
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Public Health
utslib.copyright.status	open_access	*
pubs.consider-herdc	false
dc.date.updated	2022-11-09T03:59:19Z
pubs.issue	1
pubs.publication-status	Published
pubs.volume	22
utslib.citation.issue	1

Abstract:

INTRODUCTION: Out-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. METHODS: Secondary 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. RESULTS: The 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). CONCLUSION: Our 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.

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http://hdl.handle.net/10453/163366