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

Aboagye, Richard Gyan; Okyere, Joshua; Seidu, Abdul‐Aziz; Zegeye, Betregiorgis; Amu, Hubert; Yaya, Sanni

doi:10.1186/s12913-022-07601-6

Cited by 25 publications

(20 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We also found that women with health insurance coverage had a higher likelihood of utilizing quality ANC as compared to their counterparts with no health insurance coverage. This affirms the findings of Dadjo, Ahinkorah and Yaya [ 34 ] and Aboagye et al [ 35 ] that also found health insurance coverage has a significant association with the utilization of ANC. This could be attributed to the fact that health insurance eliminates the financial barriers that could have prevented women from seeking quality ANC services.…”

Section: Discussionsupporting

confidence: 91%

Socio-economic disadvantage and quality Antenatal Care (ANC) in Sierra Leone: Evidence from Demographic and Health Survey

Dickson

Ameyaw²,

Akpeke

et al. 2023

PLoS ONE

View full text Add to dashboard Cite

Introduction Reduction of maternal mortality remains a global priority as highlighted by the third Sustainable Development Goal (SDG). This is critical in the case of Sierra Leone as the country is one of three (3) countries with the highest maternal mortality ratio globally, thus 1,120 per 100,000 live births. The approximate lifetime risk of maternal mortality in the country is 1 in 17, relative to 1 in 3,300 in high-income countries. These raise doubt about the quality of the continuum of maternal healthcare in the country, particularly antenatal care and as a result, the objective of the present study is to investigate the association between socio-economic disadvantage and quality antenatal care service utilisation as well as associated correlates in Sierra Leone. Materials and methods The study used data from the most recent Demographic and Health Survey (DHS) of Sierra Leone. Only women who had given birth in the five years preceding the survey were included, which is 6,028. Quality antenatal care was defined as receipt of recommended ANC services including uptake of recommended pregnancy drugs (e.g. Fansidar and iron supplement); injections (e.g. tetanus injection) and having some samples (e.g. blood and urine sample) and health status indicators (e.g. blood pressure) taken. An index was created from these indicators with scores ranging from 0 to 6. The scores 0 to 5 were labelled as “incomplete” and 6 was labelled as “complete” and this was used to create a dummy variable. In analysing the data, descriptive analysis was done using chi-square test as well as an inferential analysis using bivariate and multivariate models. Results Socio-economic disadvantaged [1.46 (1.09, 1.95), place of residence [2.29 (1.43, 3.67)], frequency of listening to radio [1.58 (1.20, 2.09)], health insurance coverage [3.48 (1.40, 8.64)], getting medical help for self: permission to go [0.53(0.42, 0.69) were seen to have significant relationship with quality of ANC utilized by women during pregnancy. Also, women Mende ethnicity are more likely to utilise quality ANC compared to women from the Temne ethnicity [2.58 (1.79, 3.72)]. Conclusion Policy makers could consider measures to boost patronage of quality ANC in Sierra Leone by targeting the socio-economically disadvantaged women. Targeting these sub-groups with pro- maternal and child health (MCH) interventions would help Sierra Leone achieve Goal 3 of the SDGs.

show abstract

Section: Discussionsupporting

confidence: 91%

Socio-economic disadvantage and quality Antenatal Care (ANC) in Sierra Leone: Evidence from Demographic and Health Survey

Dickson

Ameyaw²,

Akpeke

et al. 2023

PLoS ONE

View full text Add to dashboard Cite

show abstract

“…Women who had health insurance coverage were 1.64 times more likely to complete all 11 MNCH care interventions along with the CoC as compared to their colleagues who had no health insurance coverage. Often, women miss out on MNCH care intervention due to out-of-pocket-payment that usually lead to catastrophic health expenditure [ 6 ]. As such, health insurance becomes the intervention that allows them to go through the CoC while minimizing or completely avoiding out-of-pocket payments.…”

Section: Discussionmentioning

confidence: 99%

“…For instance, it is known from the literature that SSA accounts for almost 90% of the global burden of maternal mortality [5]. This high burden of maternal and child mortality in SSA has been linked to several preventable factors including low antenatal care (ANC) utilisation as well as low uptake of postnatal care (PNC), skilled attendant delivery, and health facility delivery [3,6]. Moreover, evidence suggests that easy accessibility to maternal and child healthcare is associated with significantly lower odds of child and maternal mortalities [7,8].…”

Section: Introductionmentioning

confidence: 99%

“…There is the preponderance of evidence in SSA that have examined factors associated with individual components of the CoC. For instance, Aboagye et al [6] assessed timely ANC attendance in SSA. Other studies conducted in SSA have also examined the factors associated with skilled birth attendance [12], home deliveries [13], PNC utilisation [14], breastfeeding [15], and vaccination [16].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Continuum of care for maternal, newborn, and child health in 17 sub-Saharan African countries

Seidu

Aboagye

Okyere

et al. 2022

BMC Health Serv Res

Self Cite

View full text Add to dashboard Cite

Background Given the intricate relationship between mothers and their children with the continuum of care, it is quintessential for their healthcare and interventions to be enhanced through a continuum of care approach. We examined the factors associated with the continuum of care for maternal, newborn, and child health in sub-Saharan Africa. Methods Data for the study were pooled from the Demographic and Health Surveys of 17 countries in sub-Saharan Africa. We extracted the data from the women’s files in all 17 countries. We included 15,359 married and cohabiting women with the most recent children aged 12–23 months at the time of the survey in the study. Multivariable multilevel logistic regression analysis was performed to examine the factors associated with continuum of care. Results were presented as adjusted odds ratios (aORs) with their 95% confidence interval. Results Women whose partners had secondary or higher level of education [aOR = 1.52; 95%CI = 1.07, 2.16], those with health insurance [aOR = 1.64; 95%CI = 1.18, 2.30], those who decide alone on their healthcare [aOR = 1.38; 95%CI = 1.01, 1.89], those with joint healthcare decision [aOR = 1.33; 95%CI = 1.02, 1.74], those exposed to radio [aOR = 1.38; 95%CI = 1.06, 1.79], those who started antenatal care early [aOR = 1.88; 95%CI = 1.50, 2.36] and those in southern Africa [aOR = 7.02; 95%CI = 3.23, 15.27] had higher odds of completing the continuum of care. Conclusion We found that only 3.4% of women across the 17 sub-Saharan African countries included in this study completed all of the 11 maternal, newborn, and child health care interventions along the continuum of care. The factors that are associated with the maternal, newborn, and child health continuum of care include women’s autonomy in decision-making, partners’ level of education, health insurance coverage, early initiation of antenatal care, exposure to radio, and residing in Southern Africa. Problem with the distance to the facility lowered women’s odds of completing the continuum of care. Governments and departments of health services across sub-Saharan African countries must leverage the radio to disseminate critical messages about the need to complete the continuum of care. Much commitment must be made toward advancing the autonomy of women. Health insurance coverage would have to be extended to reach all women to facilitate the completion of the continuum of care.

show abstract

“…Higher wealth index provides women with autonomy and control over resources. Hence, empowering women to take decisions to utilise skilled ANC services [ 22 ]. This affirms our findings that women who consider getting money needed for treatment as not a big problem have higher likelihood of utilising ANC services from skilled providers as compared to those who consider that as a big problem.…”

Section: Discussionmentioning

confidence: 99%

Skilled antenatal care services utilisation in sub-Saharan Africa: a pooled analysis of demographic and health surveys from 32 countries

Dickson

Okyere

Seidu

et al. 2022

BMC Pregnancy Childbirth

Self Cite

View full text Add to dashboard Cite

Background Each day, an estimated 800 women die from preventable pregnancy and childbirth related complications, where 99% of these avoidable deaths happen in low-and middle-income countries. Skilled attendance during antenatal care (ANC) plays a role in reducing maternal and child mortality. However, the factors that predict the utilisation of skilled ANC services in sub-Saharan Africa (SSA) remains sparsely investigated. Therefore, we examined women’s utilisation of skilled ANC services in SSA. Methods The research used pooled data from the most recent Demographic and Health Surveys conducted in 32 countries in SSA between January 1, 2010, and December 31, 2019. Binary logistic regression was used to examine the predictors of skilled ANC services utilisation. The results are presented as crude and adjusted odds ratios (aOR) with 95% confidence interval (CI). Results The prevalence of skilled ANC services utilisation in SSA was 76.0%, with the highest and lowest prevalence in Gambia (99.2%) and Burundi (8.4%), respectively. Lower odds of ANC from skilled providers was found among women aged 45–49 compared to those aged 20–24 (aOR = 0.86, CI = 0.79–0.94); widowed women compared to married women (aOR = 0.84, CI = 0.72–0.99); women who consider getting permission to visit the health facility as a big problem compared to those who consider that as not a big problem (aOR = 0.74, CI = 0.71–0.77); women who consider getting money needed for treatment as not a big problem compared to those who consider that as a big problem (aOR = 0.84, CI = 0.72–0.99); and women who consider distance to the health facility as a big problem compared to those who consider that as not a big problem (aOR = 0.75, CI = 0.72–0.77). Conclusion SSA has relatively high prevalence of skilled ANC services utilisation, however, there are substantial country-level disparities that need to be prioritised. Increasing maternal reproductive age being widowed and far distance to health facility were factors that predicted lower likelihood of skilled ANC services utilisation. There is, therefore, the need to intensify female formal education, invest in community-based healthcare facilities in rural areas and leverage on the media in advocating for skilled ANC services utilisation.

show abstract

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

Cited by 25 publications

References 41 publications

Socio-economic disadvantage and quality Antenatal Care (ANC) in Sierra Leone: Evidence from Demographic and Health Survey

Socio-economic disadvantage and quality Antenatal Care (ANC) in Sierra Leone: Evidence from Demographic and Health Survey

Continuum of care for maternal, newborn, and child health in 17 sub-Saharan African countries

Skilled antenatal care services utilisation in sub-Saharan Africa: a pooled analysis of demographic and health surveys from 32 countries

Contact Info

Product

Resources

About