西非的医疗保险覆盖范围和儿童及孕产妇卫生服务的可及性：一项系统评价研究方案。

Health insurance coverage and access to child and maternal health services in West Africa: a study protocol for a systematic review.

机构信息

Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.

Centre for Quality and Patient Safety Research, School of Nursing and Midwifery, Deakin University, Burwood, Melbourne, Victoria, Australia.

出版信息

Syst Rev. 2021 Mar 11;10(1):74. doi: 10.1186/s13643-021-01628-2.

DOI:10.1186/s13643-021-01628-2

PMID:33706786

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7950425/

Abstract

BACKGROUND

Though many studies have discussed the impact of health insurance on access to medical services, few have considered Western Africa. Despite decades of targeted efforts, West Africa has the most elevated maternal mortality rates (MMR) and under-five mortality rates in the world. The solution to this issue is widely believed to be the implementation of universal health coverage (UHC) as most causes of death could be effectively dealt with through primary health care providers. It is possible that UHC without additional efforts to tackle important determinants of health such as education and poverty is insufficient. The objective of this study is to examine the link between being covered by health insurance and access to health services for mothers and children in West Africa.

METHODS

A systematic literature review will be conducted. We will search the online databases MEDLINE complete, Embase, CINAHL complete, and Global Health from inception onwards. The focus will be on primary research studies and grey literature that examined health insurance in relation to access to maternal and child health services. Two reviewers will independently screen all citations, full-text articles, and abstract data. The primary outcome will be maternal and child access to health insurance and access to primary and secondary services such as attending the minimum number of prenatal visits and accessing services in emergency circumstances where catastrophic expenditures may have been an obstacle. A standardized data extraction form by the Cochrane library will be used. A narrative synthesis will be conducted with a summary of findings tables to be produced.

DISCUSSION

The systematic review will present findings on the impact of access to health insurance on access to maternal and child health care. The findings will inform discussion around the pursuit of UHC as a key health systems policy. The final manuscript will be disseminated through peer-reviewed journal and scientific conferences.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42020203859.

摘要

背景

尽管许多研究都讨论了医疗保险对获得医疗服务的影响，但很少有研究关注西非。尽管几十年来一直有针对性的努力，但西非的孕产妇死亡率（MMR）和五岁以下儿童死亡率是世界上最高的。人们普遍认为，解决这一问题的办法是实施全民健康覆盖（UHC），因为大多数死因都可以通过初级卫生保健提供者有效处理。如果不额外努力解决教育和贫困等重要健康决定因素，全民健康覆盖可能是不够的。本研究的目的是探讨西非母婴医疗保险覆盖与获得卫生服务之间的关系。

方法

将进行系统文献综述。我们将从一开始就搜索在线数据库 MEDLINE 完整、Embase、CINAHL 完整和全球健康。重点将放在与母婴健康服务的医疗保险有关的原始研究和灰色文献上。两名审查员将独立筛选所有引用、全文文章和摘要数据。主要结果将是母婴获得医疗保险和获得初级和二级服务的机会，如参加最低数量的产前检查，并在可能存在灾难性支出障碍的紧急情况下获得服务。将使用 Cochrane 图书馆的标准化数据提取表。将进行叙述性综合，并制作总结发现的表格。