Increasing health insurance enrolment in the informal economic sector

Onasanya, Adeola

doi:10.7189/jogh.10.010329

Cited by 3 publications

(2 citation statements)

References 5 publications

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“…They are likely to engage in sporting activities at this stage of their lives, and adopt healthy behaviors in order to avoid declining health status, so they will opt for health insurance coverage. Previous studies have indicated that older persons might tend to increase their participation as health insurance subscribers compared to younger age groups [47,62]. Consistent with earlier studies, our finding established the possibility of having health insurance coverage rise with increasing age [14,32,63].…”

Section: Discussionsupporting

confidence: 92%

“…The willingness of government and non-governmental agencies to disburse the necessary funds to the health sector in developing countries has been associated with a lack of political will, fraud and corruption within the health system [20,21]. Sustainable development and sustaining health financing remain pertinent in light of social, demographic and epidemiological changes [57][58][59][60][61][62][63][64][65][66][67][68][69][70][71][72], and the incidence of financing health system viability has long been a major subject of health policy problems across the globe, and in sub-Saharan African countries, such as in Nigeria and South Africa [1][2][3][4].…”

Section: Further Discussion: Sustaining Health Insurance Coverage Via...mentioning

confidence: 99%

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A Comparative Cross-Sectional Study of the Prevalence and Determinants of Health Insurance Coverage in Nigeria and South Africa: A Multi-Country Analysis of Demographic Health Surveys

Akokuwebe

Idemudia

2022

IJERPH

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Background: The core Universal Health Coverage (UHC) objectives are to ensure universal access to healthcare services by reducing all forms of inequalities. However, financial constraints are major barriers to accessing healthcare, especially in countries such as Nigeria and South Africa. The findings of this study may aid in informing and communicating health policy to increase financial access to healthcare and its utilization in South Africa and Nigeria. Nigeria-South Africa bilateral relations in terms of politics, economics and trade are demonstrated in the justification of the study setting selection. The objectives were to estimate the prevalence of health insurance coverage, and to explore the socio-demographic factors associated with health insurance in South Africa and Nigeria. Methods: This was a cross-sectional study using the 2018 Nigeria Demographic Health Survey and the 2016 South Africa Demographic Health Survey. The 2018 Nigeria Demographic Health Survey data on 55,132 individuals and the 2016 South Africa Demographic Health Survey on 12,142 individuals were used to investigate the prevalence of health insurance associated with socio-demographic factors. Percentages, frequencies, Chi-square and multivariate logistic regression were e mployed, with a significance level of p < 0.05. Results: About 2.8% of the Nigerian population and 13.3% of the South African population were insured (Nigeria: males—3.4%, females—2.7% vs. South Africa: males—13.9%, females—12.8%). The multivariate logistic regression analyses showed that higher education was significantly more likely to be associated with health insurance, independent of other socio-demographic factors in Nigeria (Model I: OR: 1.43; 95% CI: 0.34–1.54, p < 0.05; Model II: OR: 1.34; 95% CI: 0.28–1.42, p < 0.05) and in South Africa (Model I: OR: 1.33; 95% CI: 0.16–1.66, p < 0.05; Model II: OR: 1.76; 95% CI: 0.34–1.82, p < 0.05). Respondents with a higher wealth index and who were employed were independently associated with health insurance uptake in Nigeria and South Africa (p < 0.001). Females were more likely to be insured (p < 0.001) than males in both countries, and education had a significant impact on the likelihood of health insurance uptake in high wealth index households among both male and females in Nigeria and South Africa. Conclusion: Health insurance coverage was low in both countries and independently associated with socio-demographic factors such as education, wealth and employment. There is a need for continuous sensitization, educational health interventions and employment opportunities for citizens of both countries to participate in the uptake of wide health insurance coverage.

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Section: Discussionsupporting

confidence: 92%

Section: Further Discussion: Sustaining Health Insurance Coverage Via...mentioning

confidence: 99%

A Comparative Cross-Sectional Study of the Prevalence and Determinants of Health Insurance Coverage in Nigeria and South Africa: A Multi-Country Analysis of Demographic Health Surveys

Akokuwebe

Idemudia

2022

IJERPH

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Reimagining the Nigerian Healthcare System to Achieve Universal and High-Quality Health Care by 2030

Balogun

2021

The Nigerian Healthcare System

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Women empowerment and health insurance utilisation in Rwanda: a nationwide cross-sectional survey

Kawuki

Gatasi

Sserwanja³

2022

BMC Women's Health

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Background Health insurance coverage is one of the several measures being implemented to reduce the inequity in access to quality health services among vulnerable groups. Although women’s empowerment has been viewed as a cost-effective strategy for the reduction of maternal and child morbidity and mortality, as it enables women to tackle the barriers to accessing healthcare, its association with health insurance usage has been barely investigated. Our study aims at examining the prevalence of health insurance utilisation and its association with women empowerment as well as other socio-demographic factors among Rwandan women. Methods We used Rwanda Demographic and Health Survey (RDHS) 2020 data of 14,634 women aged 15–49 years, who were selected using multistage sampling. Health insurance utilisation, the outcome variable was a binary response (yes/no), while women empowerment was assessed by four composite indicators; exposure to mass media, decision making, economic and sexual empowerment. We conducted multivariable logistic regression to explore its association with socio-demographic factors, using SPSS (version 25). Results Out of the 14,634 women, 12,095 (82.6%) (95% CI 82.0–83.2) had health insurance, and the majority (77.2%) were covered by mutual/community organization insurance. Women empowerment indicators had a negative association with health insurance utilisation; low (AOR = 0.85, 95% CI 0.73–0.98) and high (AOR = 0.66, 95% CI 0.52–0.85) exposure to mass media, high decision making (AOR = 0.78, 95% CI 0.68–0.91) and high economic empowerment (AOR = 0.63, 95% CI 0.51–0.78). Other socio-demographic factors found significant include; educational level, wealth index, and household size which had a negative association, but residence and region with a positive association. Conclusions A high proportion of Rwandan women had health insurance, but it was negatively associated with women’s empowerment. Therefore, tailoring mass-media material considering the specific knowledge gaps to addressing misinformation, as well as addressing regional imbalance by improving women’s access to health facilities/services are key in increasing coverage of health insurance among women in Rwanda.

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Increasing health insurance enrolment in the informal economic sector

Cited by 3 publications

References 5 publications

A Comparative Cross-Sectional Study of the Prevalence and Determinants of Health Insurance Coverage in Nigeria and South Africa: A Multi-Country Analysis of Demographic Health Surveys

A Comparative Cross-Sectional Study of the Prevalence and Determinants of Health Insurance Coverage in Nigeria and South Africa: A Multi-Country Analysis of Demographic Health Surveys

Reimagining the Nigerian Healthcare System to Achieve Universal and High-Quality Health Care by 2030

Women empowerment and health insurance utilisation in Rwanda: a nationwide cross-sectional survey

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