scholarly journals Health insurance coverage and maternal healthcare services utilization in Jordan: evidence from the 2017–18 Jordan demographic and health survey

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Petula Fernandes ◽  
Emmanuel Kolawole Odusina ◽  
Bright Opoku Ahinkorah ◽  
Komlan Kota ◽  
Sanni Yaya
Keyword(s):  
Health Insurance ◽  
Antenatal Care ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Healthcare Services ◽  
Skilled Birth Attendance ◽  
Reproductive Age ◽  
Maternal Healthcare ◽  
Services Utilization ◽  
Birth Attendance

Abstract Background Despite the relationship between health insurance coverage and maternal healthcare services utilization, previous studies in Jordan on the use of maternal healthcare services have mainly focused on patterns and determinants of maternal healthcare services utilization in Jordan. Therefore, this study investigated the relationship between health insurance coverage and maternal healthcare services utilization in Jordan. Methods This study used secondary data published in 2017-18 Jordan Demographic and Health Survey on 4656 women of reproductive age (15–49 years). The independent variable was health insurance coverage and the outcome variable was maternal healthcare services utilization, measured through timing of first antenatal visit, four or more antenatal care visits, and skilled birth attendance. The data were analyzed using descriptive statistics and binary logistic regression. Results Out of the total number of women who participated in the study, 38.2% were not covered by health insurance. With maternal healthcare utilization, 12.5%, 23.2%, and 10.1% respectively, failed to make early first antenatal care visit, complete four or more antenatal care visits and have their delivery attended by a skilled worker. After controlling for the socio-demographic factors, health insurance coverage was associated with increased odds of early timing of first antenatal care visits and completion of four or more antenatal care visits (aOR = 1.33, p < 0.05, aOR = 1.25, p < 0.01, respectively). However, women who were covered by health insurance were less likely to use skilled birth attendance during delivery (aOR = 0.72 p < 0.001). Conclusions Jordanian women with health insurance coverage were more likely to have early first antenatal care visits and complete four or more antenatal care visits. However, they were less likely to have their delivery attended by a skilled professional. This study provides evidence that health insurance coverage has contributed to increased maternal healthcare services utilization, only in terms of number and timing of antenatal care visits in Jordan. It is recommended that policy makers in Jordan should strengthen the coverage of health insurance in the country, especially among women of reproductive age in order to enhance the use of maternal healthcare services in the country.

scholarly journals Predictors of skilled birth attendance among married women in Cameroon: further analysis of 2018 Cameroon Demographic and Health Survey

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Sanni Yaya ◽  
Betregiorgis Zegeye ◽  
Bright Opoku Ahinkorah ◽  
Abdul-Aziz Seidu ◽  
Edward Kwabena Ameyaw ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Maternal Education ◽  
Economic Status ◽  
Healthcare Services ◽  
Skilled Birth Attendance ◽  
Married Women ◽  
Maternal Healthcare ◽  
Maternal Deaths ◽  
Services Utilization ◽  
Birth Attendance

Abstract Background In Cameroon, maternal deaths remain high. The high maternal deaths in the country have been attributed to the low utilization of maternal healthcare services, including skilled birth attendance. This study examined the predictors of skilled birth services utilization among married women in Cameroon. Methods Data from the 2018 Cameroon Demographic and Health Survey was analyzed on 7881 married women of reproductive age (15–49 years). Both bivariate and multivariable logistic regression analyses were carried out to determine the predictors of skilled childbirth services. The results were presented with crude odds ratio (cOR) and adjusted odds ratio (aOR) and 95% confidence interval (CI). Results The coverage of skilled birth attendance among married women of reproductive age in Cameroon was 66.2%. After adjusting for potential confounders, media exposure (aOR = 1.46, 95% CI: 1.11–1.91), higher decision making (aOR = 1.88, 95% CI: 1.36–2.59), maternal education (aOR = 2.38, 95% CI; 1.65–3.42), place of residence (aOR = 0.50, 95% CI; 0.33–0.74), religion (aOR = 0.55, 95% CI; 0.35–0.87), economic status (aOR = 5.16, 95% CI; 2.58–10.30), wife beating attitude (aOR = 1.32, 95% CI; 1.05–1.65), parity (aOR = 0.62, 95% CI; 0.41–0.93) and skilled antenatal care (aOR = 14.46, 95% CI; 10.01–20.89) were found to be significant predictors of skilled birth attendance. Conclusions This study demonstrates that social, economic, regional, and cultural factors can act as barriers to skilled childbirth services utilization in Cameroon. Interventions that target women empowerment, antenatal care awareness and strengthening are needed, especially among the rural poor, to reduce barriers to care seeking. Maternal healthcare services utilization interventions and policies in Cameroon need to focus on specific equity gaps that relate to socio-economic status, maternal education, and the economic empowerment of women. Such policies and interventions should also aim at reducing geographical barriers to access to maternal healthcare services, including skilled birth attendance. Due to the presence of inequities in the use of skilled birth attendance services, programs aimed at social protection and empowerment of economically disadvantaged women are necessary for the achievement of the post-2015 targets and the Sustainable Development Goals. Plain English Summary Globally, Cameroon is one of the countries with high maternal deaths. Low utilization of maternal healthcare services, including skilled birth attendance have been found to account for the high maternal deaths in the country. This study sought to examine the factors associated with skilled childbirth services utilization among married women in Cameroon. Using data from the 2018 Cameroon Demographic and Health Survey, we found that the coverage of skilled birth attendance among married women of reproductive age in Cameroon is high. Factors such as higher decision-making power, higher maternal education, place of residence, religion, higher economic status, wife beating attitude, parity and skilled antenatal care were found to be the significant predictors of skilled birth attendance. This study has shown that socio-economic, regional and cultural factors account for the utilization of skilled childbirth services utilization in Cameroon. Interventions aimed at enhancing the utilization of skilled childbirth services in Cameroon should target women empowerment, antenatal care awareness creation and sensitization, especially among the rural poor, to reduce barriers to care seeking. Maternal healthcare services utilization interventions and policies in Cameroon need to focus on specific equity gaps that relate to socio-economic status, maternal education, and the economic empowerment of women.

scholarly journals Inequalities in out-of-pocket health expenditure among women of reproductive age: after-effects of national health insurance scheme initiation in Ghana

2021 ◽  
Vol 96 (1) ◽  
Author(s):  
Michael Ekholuenetale ◽  
Amadou Barrow
Keyword(s):  
Health Insurance ◽  
Healthcare Utilization ◽  
Health Expenditure ◽  
Concentration Index ◽  
Insurance Coverage ◽  
Healthcare Services ◽  
Socioeconomic Disadvantage ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Maternal Healthcare

Abstract Background Improvement in maternal healthcare is a public health priority. Unfortunately, in spite of the efforts made over time regarding universal coverage, there remain issues with accessibility and use of healthcare services up to now. In this study, we examined inequalities in out-of-pocket health expenditure among women of reproductive age in Ghana. We analyzed secondary data collected in Ghana Demographic and Health Survey (GDHS) - 2014. A total of 9,002 women of reproductive age were included in this study. Lorenz curves and the concentration index were used to examine neighborhood socioeconomic disadvantage inequalities in out-of-pocket expenditure for maternal healthcare utilization Results About two thirds (66.0%) of women of reproductive age in Ghana were covered by health insurance. In sum, women of high neighborhood socioeconomic disadvantage status had the least out-of-pocket expenditure for total healthcare utilization, laboratory investigations, antenatal care visits, post-natal care visits, care for new born for up to 3 months, and other healthcare services. The converse was however true for family planning service utilization. Using Concentration Index, we quantified the degree of neighborhood socioeconomic disadvantage inequalities in healthcare service utilizations. Conclusion This study showed a gap in health insurance coverage among women of reproductive age. There were also inequalities in out-of-pocket expenditure for healthcare services utilization. It is expedient for stakeholders in the healthcare system to make policies targeted at bridging the neighborhood socioeconomic differences in maternal healthcare use and develop programs to improve women’s financial protection. Moreover, enlightenment on health insurance availability and coverage should focus on women at risk of out-of-pocket expenditure.

scholarly journals Cost of Ante-natal Care among Health Insurance (HI) Enrollees and Out-of-Pocket (OOP) Payers accessing Maternal Healthcare Services in a Tertiary Health Institution in Southwest Nigeria

2021 ◽  
Vol 9 (2) ◽  
pp. 11-22
Author(s):  
Taofeek Adedayo Sanni
Keyword(s):  
Health Insurance ◽  
Antenatal Care ◽  
Healthcare Services ◽  
Reproductive Age ◽  
P Value ◽  
Maternal Healthcare ◽  
Cross Sectional ◽  
Health Institution ◽  
Total Cost ◽  
Southwest Nigeria

Maternal Mortality Remains A Leading Cause Of Death Among Women Of Reproductive Age Group. This Study Determined The Cost Of Antenatal Care Among Health Insurance (HI) Enrollees And Out-Of-Pocket (OOP) Payers Accessing Maternal Healthcare Services In A Tertiary Health Institution In Southwest Nigeria. A Comparative Cross-Sectional Study Was Carried Out Among 380 Women (190 HI Enrollees And 190 OOP Payers) Attending Antenatal Care Services In A Tertiary Health Institution In Southwest Nigeria Using A Systematic Random Sampling Technique. Data Was Gathered Using An Interviewer-Administered Semi-Structured Questionnaire And Analyzed Using IBM SPSS Version 23. Chi-Square And Binary Logistic Regression Were Used To Assess The Association Between Dependent And Independent Variables And A P-Value Of <0.05 Was Taken As Significant. The Overall Mean Age Of Respondents In This Study Was 33.8 ± 5.0 Years (HI Group: 34.1 ± 4.9 Years And OOP Group: 33.6 ± 5.0 Years). The Mean Total Cost Of Antenatal Care (ANC) Is Lesser For HI Enrollees (₦5,095.2 ± 1,753.1 Equivalent To $13.3 ± 4.6) As Compared With OOP Payers (₦15,050.6 ± 5,548.9 Equivalent To $39.6 ± 14.6). Predictors And Enablers For HI Uptake Are Marital Status, Family Size, Level Of Education, Occupation, Appropriate And Quality HI Package, And Trust In The HI Scheme. It Was Concluded That The Total Cost Of Antenatal Care Is Lower Among The Health Insurance Enrollees Than The Out-Of-Pocket Payers. Therefore, Interventions To Increase Awareness And Designing More Enticing HI Packages Are Recommended.

scholarly journals PEMANFAATAN JAMINAN KESEHATAN DALAM PELAYANAN KESEHATAN IBU DI TUJUH KABUPATEN/KOTA DI INDONESIA

2019 ◽  
Vol 18 (2) ◽  
pp. 111-121
Author(s):  
Heny Lestary ◽  
Sugiharti Sugiharti ◽  
Suparmi Suparmi
Keyword(s):  
Health Insurance ◽  
Maternal Health ◽  
Antenatal Care ◽  
Universal Health Coverage ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Reproductive Age ◽  
Health Coverage ◽  
Delivery Services ◽  
Universal Health

ABSTRACT  Since 2014, Indonesia has been implementing universal health coverage to increase health insurance coverage. However, health insurance utilization by the community for maternal health is still low. This research aimed to determine factors related to the use of health insurance for antenatal care and delivery services among pregnant and childbirth women. The research conducted in 7 districts/cities, namely Kota Bandar Lampung, Kota Palembang, Kabupaten Lebak, Kabupaten Karawang, Kota Semarang, Kota Surabaya, dan Kota Makasar. A total of 517 respondents has been interviewed. The results showed that most respondents aged 21-34 years (68.5%), unemployed (74.7%) and graduated from high school or higher (58.4%). Around 11% of the respondent had health insurance. 73.0% of respondents who had health insurance used it for antenatal care and 88.3% used it for delivery. Multivariate analysis shows that the level of income is related to the use of health insurance for antenatal care and delivery, whereas mothers who have income level higher than Rp 2,000,000 had lower odds to utilize health insurance for antenatal care (OR=0,56; 95%CI:0,35 - 0,91) and delivery (OR=0,52; 95%CI:0,27 - 1,02). Therefore, there is a need for broader socialization of health insurance utilization for antenatal and delivery, especially for couples at reproductive age. Keywords: Health insurance, health services, maternal health   ABSTRAK Pada tahun 2014, Indonesia mulai melaksanakan Universal Health Coverage untuk meningkatkan cakupan jaminan kesehatan. Namun, pemanfaatan jaminan kesehatan oleh masyarakat untuk kesehatan ibu masih rendah. Penelitian ini bertujuan untuk mengetahui faktor yang berhubungan dengan pemanfaatan jaminan kesehatan untuk pemeriksaan kehamilan dan pelayanan persalinan pada ibu hamil dan bersalin. Penelitian dilaksanakan di 7 (tujuh) kabupaten/kota, yaitu Kota Bandar Lampung, Kota Palembang, Kabupaten Lebak, Kabupaten Karawang, Kota Semarang, Kota Surabaya, dan Kota Makasar. Sebesar 517 responden yang berhasil diwawancarai. Hasil analisis menunjukkan bahwa sebagian besar responden berumur 21 – 34 tahun (68,5%), tidak bekerja (74,7%) dan berpendidikan tamat SMA+ (58,4%). Sekitar 11,0% responden tidak memiliki jaminan kesehatan. Dari responden yang memiliki jaminan kesehatan, hanya 73,0% di antaranya yang memanfaatkan untuk pemeriksaan kehamilan dan 88,3% memanfaatkan untuk persalinan. Analisis multivariat menunjukkan bahwa tingkat pendapatan berhubungan dengan pemanfaatan jaminan kesehatan untuk pemeriksaan kehamilan, dan persalinan, dimana ibu yang memiliki tingkat pendapatan ≥Rp 2.000.000,- memiliki kemungkinan lebih rendah untuk memanfaatkan jaminan kesehatan untuk pemeriksaan kehamilan (OR=0,56; 95%CI:0,35 - 0,91) maupun persalinan (OR=0,52; 95%CI:0,27 - 1,02). Oleh sebab itu, perlu sosialisasi lebih luas agar memanfaatkan jaminan kesehatan untuk pemeriksaan kehamilan dan persalinan, terutama pada Pasangan Usia Subur (PUS). Kata kunci: Jaminan kesehatan, pelayanan kesehatan, kesehatan ibu

scholarly journals Health Insurance Deepening and Its Impact on Maternal Healthcare Demand in Private Hospitals in Kenya

2020 ◽  
Vol 16 ◽  
pp. 62-76
Author(s):  
George N. Mose ◽  
Joseph Abuga Orayo
Keyword(s):  
Health Insurance ◽  
Maternal Health ◽  
Insurance Coverage ◽  
Wealth Index ◽  
Health Insurance Coverage ◽  
Healthcare Services ◽  
Significant Rise ◽  
Probit Regression ◽  
Maternal Healthcare ◽  
Private Hospitals

Promotion of maternal healthcare services through the expansion of health insurance coverage has been a core strategy that has been adopted in the reduction of maternal and child mortalities in Kenya. In this study, we seek to establish how health insurance coverage and benefits influence the demand for maternal health utilization in private hospitals in Kenya. The study utilized the latest Kenya Demographic Household Survey 2014 data to estimate the relationship. The binary probit regression model was employed in estimation. From the findings, only 15 percent of mothers were enrolled in a health insurance plan, whereas 14 percent of the women reported to have attended antenatal clinics in private health facilities, and 13 percent benefited from skilled delivery in private healthcare facilities. Results further revealed that health insurance ownership led to a significant increase in the likelihood of utilizing maternal health care services in private hospitals in Kenya. Similarly, age of the mother, marital status, birth order, higher education level, all wealth index categories, and employment status were cofactors associated significantly with use of healthcare services. It was concluded that the advent and increase of health insurance coverage is associated with a significant rise in demand of maternal healthcare services in private hospitals. This study argues that the current health subsidies would be more effective if they were channeled through health insurance with wider coverage of private hospitals. The study recommends reforms in policies and guidelines governing insurance coverage, which we argue would significantly bring down the cost of insurance coverage, thus become more accessible to more Kenyans.

Health insurance coverage and access to skilled birth attendance in Togo

2018 ◽  
Vol 141 (2) ◽  
pp. 181-188 ◽  
Author(s):  
Komi Mati ◽  
Korede K. Adegoke ◽  
Abimbola Michael-Asalu ◽  
Hamisu M. Salihu
Keyword(s):  
Health Insurance ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Skilled Birth Attendance ◽  
Birth Attendance

scholarly journals Maternal healthcare services use in Mwanza Region, Tanzania: A cross-sectional baseline survey

2019 ◽  
Author(s):  
James Orwa ◽  
Michaela Mantel ◽  
Micheal Mugerwa ◽  
Sharon Brownie ◽  
Eunice Siaity Pallangyo ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Health Facility ◽  
Healthcare Services ◽  
Facility Delivery ◽  
Postpartum Care ◽  
Reproductive Age ◽  
Antenatal Visit ◽  
Health Facility Delivery ◽  
Maternal Healthcare ◽  
Cross Sectional

Abstract Background: Improving maternal health by reducing maternal mortality/morbidity relates to Goal 3 of the Sustainable Development Goals. Achieving this goal is supported by antenatal care (ANC), health facility delivery, and postpartum care. This study aimed to understand levels of use and correlates of uptake of maternal healthcare services among women of reproductive age (15–49 years) in Mwanza Region, Tanzania. Methods: A cross-sectional multi-stage sampling household survey was conducted to obtain data from 1476 households in six districts of Mwanza Region. Data for the 409 women who delivered in the 2 years before the survey were analyzed for three outcomes: four or more ANC visits (ANC4+), health facility delivery, and postpartum visits. Factors associated with the three outcomes were determined using generalized estimating equations to account for clustering at the district level while adjusting for all variables. Results: Of the 409 eligible women, 58.2% attended ANC4+, 76.8% delivered in a health facility, and 43.5% attended a postpartum clinic. Women from peri-urban, island, and rural regions were less likely to have completed ANC4+ or health facility delivery compared with urban women. Education and early first antenatal visit were associated with ANC4+ and health facility delivery. Mothers from peri-urban areas and those who with health facility delivery were more likely to attend postpartum check-ups. Conclusion: Use of ANC services in early pregnancy influences the number of ANC visits, leading to higher uptake of ANC4+ and health facility delivery. Postpartum check-ups for mothers and newborns are associated with health facility delivery. Encouraging early initiation of ANC visits may increase the uptake of maternal healthcare services. Keywords: Antenatal care, health facility delivery, postpartum care, Mwanza, Tanzania

scholarly journals Correlates of health care access problems among reproductive age women in Ethiopia: In-depth analysis of 2016 Ethiopia demographic Health Survey

2019 ◽  
Author(s):  
koku Tamirat ◽  
Zemenu Tadesse Tessema ◽  
Fentahun Bikale Kebede
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Care Access ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Reproductive Age ◽  
Rural Residence ◽  
Factors Associated ◽  
Care Access ◽  
Reproductive Age Women

Abstract Background Health care access is timely use of personal health services to achieve best health outcomes. Difficulties to access health care among reproductive age women may led to different negative health outcomes to death and disability. Therefore, this study aimed to assess factors associated with problems of accessing health care among reproductive age women in Ethiopia.Method This study was based on 2016 Ethiopia Demography and Health Survey. Individual women record (IR) file was used to extract the dataset and 15, 683 women were included in the final analysis. A composite variable of problem of accessing health care were created from four questions used to rate problem of accessing health care among reproductive age women. Generalized estimating equation (GEE) model was fitted to identify factors associated with problem of accessing health care. Crude and Adjusted odds ratio with a 95%CI computed to assess the strength of association between independent and outcome variables.Result In this study the magnitude of problem in accessing health care among reproductive age women was 69.9% of with 95%CI (69.3 to 70.7). Rural residence (AOR= 2.13, 95%CI: 1.79 to 2.53), women age 35-49 years (AOR= 1.24, 95%CI: 1.09 to 1.40), married/live together (AOR= 0.72, 95%CI: 0.64 to 0.81), had health insurance coverage (AOR=0.83, 95%CI: 0.70 to 0.95), wealth index [middle (AOR=0.75,95%CI: 0.66 to 0.85) and rich (AOR=0.47,95%CI:0.42 to 0.53)], primary education(AOR= 0.80, 95%CI: 0.73 to 0.88), secondary education (AOR= 0.57, 95%CI:0.50 to 0.64) and diploma and higher education (AOR= 0.43, 95%CI: 0.37 to 0.50) were factors associated with problem of health care access among reproductive age women.Conclusion Despite better coverage of health system, problems of health care access among reproductive age women were considerably high. Health insurance coverage, middle and rich wealth, primary and above educational level were negatively associated with problems health care access. In contrast, older age and rural residence were positively associated with problems of health care access among reproductive age women. This suggests that further interventions are necessary to increase universal reproductive health care access for the achievement of sustainable development goals.

scholarly journals Inequality in healthcare use among older people in Colombia

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Jorge Garcia-Ramirez ◽  
Zlatko Nikoloski ◽  
Elias Mossialos
Keyword(s):  
Health Insurance ◽  
Health Services ◽  
Healthcare Utilization ◽  
Insurance Coverage ◽  
Wealth Quintile ◽  
The Elderly ◽  
Health Insurance Coverage ◽  
Healthcare Services ◽  
Access To Healthcare ◽  
Healthcare Use

Abstract Background Since the early 1990s, Colombia has made great strides in extending healthcare coverage to its population. In order to measure the impact of these efforts, it is important to assess whether the introduction of universal health coverage has translated into equitable access to healthcare in the country, particularly for the elderly. Thus, in this study we assessed the inequality in utilization of health services among elderly patients in Colombia. In addition, we identified the determinants of healthcare utilization. Methods We analyzed the 2015 Colombian health, well-being and aging study (SABE). To classify determinants of healthcare use into predisposing, enabling and need factors, we employed the Anderson framework of healthcare utilization. Use of outpatient, inpatient and preventive health services constituted the dependent variables. We performed multivariate logistic regressions, estimated concentration indexes (CI) and performed decomposition analyses of the CIs to determine the contribution of various determinants to inequality of healthcare utilization. Results The study sample included 23,694 adults over 60-years-old. Wealth quintile, urban dwelling, health insurance type and multimorbidity predicted the utilization of all types of healthcare services except for hospitalization. Aside from inpatient care, pro-rich inequality in utilization of healthcare services was present. Wealth quintile and type of health insurance were the largest contributors to pro-rich inequality in use of preventive services. Conclusions While there has been progress in health insurance coverage for the elderly in Colombia, there are still equality challenges in the delivery of healthcare, especially for preventive and outpatient care. These inequalities are driven by individual characteristics such as wealth, urban residence, type of health insurance carried, and presence of multimorbidity. To address this issue, the Colombian health system should extend health insurance coverage to uninsured populations, as well as reduce barriers of access to healthcare services among poorest and the rural population receiving subsidized insurance.

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