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Health insurance coverage among women of reproductive age in rural Ghana: policy and equity implications
BACKGROUND: Globally, health insurance has been identified as a key component of healthcare financing. The implementation of health insurance policies in low and middle-income countries has led to a significant increase in access to healthcare services in these countries. This study assessed health...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10349408/ https://www.ncbi.nlm.nih.gov/pubmed/37452351 http://dx.doi.org/10.1186/s12961-023-01019-0 |
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author | Ayanore, Martin Afaya, Agani Kumbeni, Maxwell Tii Laari, Timothy Tienbia Ahinkorah, Bright Opoku Salia, Solomon Mohammed Bam, Victoria Yakong, Vida Nyagre Afaya, Richard Adongo Alhassan, Robert Kaba Seidu, Abdul-Aziz |
author_facet | Ayanore, Martin Afaya, Agani Kumbeni, Maxwell Tii Laari, Timothy Tienbia Ahinkorah, Bright Opoku Salia, Solomon Mohammed Bam, Victoria Yakong, Vida Nyagre Afaya, Richard Adongo Alhassan, Robert Kaba Seidu, Abdul-Aziz |
author_sort | Ayanore, Martin |
collection | PubMed |
description | BACKGROUND: Globally, health insurance has been identified as a key component of healthcare financing. The implementation of health insurance policies in low and middle-income countries has led to a significant increase in access to healthcare services in these countries. This study assessed health insurance coverage and its associated factors among women of reproductive age living in rural Ghana. METHODS: This study used a nationally representative data from the 2017/2018 Ghana Multiple Indicator Cluster Survey (GMICS) and included 7340 rural women aged 15–49 years. Bivariate and multivariable logistic regression models were developed to assess the association between the explanatory and the outcome variable. Statistical significance was considered at p = 0.05. RESULTS: The overall prevalence of health insurance coverage among rural women in Ghana was 51.9%. Women with secondary (aOR = 1.72, 95% CI: 1.38–2.14) and higher education (aOR = 4.57, 95% CI: 2.66–7.84) were more likely to have health insurance coverage than those who had no formal education. Women who frequently listened to radio (aOR = 1.146, 95% CI: 1.01–1.30) were more likely to have health insurance coverage than those who did not. Women who had a child (aOR = 1.81, 95% CI: 1.50–2.17), two children (aOR = 1.59, 95% CI: 1.27–1.98), three children (aOR = 1.41, 95% CI: 1.10–1.80), and five children (aOR = 1.36, 95% CI: 1.03–1.79) were more likely to have health insurance coverage than those who had not given birth. Women who were pregnant (aOR = 3.52, 95% CI: 2.83–4.38) at the time of the survey, and women within the richest households (aOR = 3.89, 95% CI: 2.97–5.10) were more likely to have health insurance coverage compared to their other counterparts. Women in the Volta region (aOR = 1.36, 95% CI: 1.02–1.81), Brong Ahafo region (aOR = 2.82, 95% CI: 2.20–3.60), Northern region (aOR = 1.32, 95% CI: 1.02–1.70), Upper East region (aOR = 2.13, 95% CI: 1.63–2.80) and Upper West region (aOR = 1.56, 95% CI: 1.20–2.03) were more likely to have health insurance coverage than those in the Western region. CONCLUSION: Although more than half of women were covered by health insurance, a significant percentage of them were uninsured, highlighting the need for prompt policy actions to improve coverage levels for insurance. It was found that educational level, listening to radio, parity, pregnancy status, wealth quintile, and region of residence were factors associated with health insurance coverage. We recommend better targeting and prioritization of vulnerability in rural areas and initiate policies that improve literacy and community participation for insurance programs. Further studies to establish health policy measures and context specific barriers using experimental designs for health insurance enrolments are required. |
format | Online Article Text |
id | pubmed-10349408 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-103494082023-07-16 Health insurance coverage among women of reproductive age in rural Ghana: policy and equity implications Ayanore, Martin Afaya, Agani Kumbeni, Maxwell Tii Laari, Timothy Tienbia Ahinkorah, Bright Opoku Salia, Solomon Mohammed Bam, Victoria Yakong, Vida Nyagre Afaya, Richard Adongo Alhassan, Robert Kaba Seidu, Abdul-Aziz Health Res Policy Syst Research BACKGROUND: Globally, health insurance has been identified as a key component of healthcare financing. The implementation of health insurance policies in low and middle-income countries has led to a significant increase in access to healthcare services in these countries. This study assessed health insurance coverage and its associated factors among women of reproductive age living in rural Ghana. METHODS: This study used a nationally representative data from the 2017/2018 Ghana Multiple Indicator Cluster Survey (GMICS) and included 7340 rural women aged 15–49 years. Bivariate and multivariable logistic regression models were developed to assess the association between the explanatory and the outcome variable. Statistical significance was considered at p = 0.05. RESULTS: The overall prevalence of health insurance coverage among rural women in Ghana was 51.9%. Women with secondary (aOR = 1.72, 95% CI: 1.38–2.14) and higher education (aOR = 4.57, 95% CI: 2.66–7.84) were more likely to have health insurance coverage than those who had no formal education. Women who frequently listened to radio (aOR = 1.146, 95% CI: 1.01–1.30) were more likely to have health insurance coverage than those who did not. Women who had a child (aOR = 1.81, 95% CI: 1.50–2.17), two children (aOR = 1.59, 95% CI: 1.27–1.98), three children (aOR = 1.41, 95% CI: 1.10–1.80), and five children (aOR = 1.36, 95% CI: 1.03–1.79) were more likely to have health insurance coverage than those who had not given birth. Women who were pregnant (aOR = 3.52, 95% CI: 2.83–4.38) at the time of the survey, and women within the richest households (aOR = 3.89, 95% CI: 2.97–5.10) were more likely to have health insurance coverage compared to their other counterparts. Women in the Volta region (aOR = 1.36, 95% CI: 1.02–1.81), Brong Ahafo region (aOR = 2.82, 95% CI: 2.20–3.60), Northern region (aOR = 1.32, 95% CI: 1.02–1.70), Upper East region (aOR = 2.13, 95% CI: 1.63–2.80) and Upper West region (aOR = 1.56, 95% CI: 1.20–2.03) were more likely to have health insurance coverage than those in the Western region. CONCLUSION: Although more than half of women were covered by health insurance, a significant percentage of them were uninsured, highlighting the need for prompt policy actions to improve coverage levels for insurance. It was found that educational level, listening to radio, parity, pregnancy status, wealth quintile, and region of residence were factors associated with health insurance coverage. We recommend better targeting and prioritization of vulnerability in rural areas and initiate policies that improve literacy and community participation for insurance programs. Further studies to establish health policy measures and context specific barriers using experimental designs for health insurance enrolments are required. BioMed Central 2023-07-14 /pmc/articles/PMC10349408/ /pubmed/37452351 http://dx.doi.org/10.1186/s12961-023-01019-0 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Ayanore, Martin Afaya, Agani Kumbeni, Maxwell Tii Laari, Timothy Tienbia Ahinkorah, Bright Opoku Salia, Solomon Mohammed Bam, Victoria Yakong, Vida Nyagre Afaya, Richard Adongo Alhassan, Robert Kaba Seidu, Abdul-Aziz Health insurance coverage among women of reproductive age in rural Ghana: policy and equity implications |
title | Health insurance coverage among women of reproductive age in rural Ghana: policy and equity implications |
title_full | Health insurance coverage among women of reproductive age in rural Ghana: policy and equity implications |
title_fullStr | Health insurance coverage among women of reproductive age in rural Ghana: policy and equity implications |
title_full_unstemmed | Health insurance coverage among women of reproductive age in rural Ghana: policy and equity implications |
title_short | Health insurance coverage among women of reproductive age in rural Ghana: policy and equity implications |
title_sort | health insurance coverage among women of reproductive age in rural ghana: policy and equity implications |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10349408/ https://www.ncbi.nlm.nih.gov/pubmed/37452351 http://dx.doi.org/10.1186/s12961-023-01019-0 |
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