埃塞俄比亚健康保险参保与妇女医疗服务利用的关联
Association between health insurance enrolment and maternal health care service utilization among women in Ethiopia.
机构信息
Department of Midwifery, Woldia University, Woldia, Ethiopia.
Department of Public Health, Woldia University, Woldia, Ethiopia.
出版信息
BMC Public Health. 2021 Dec 30;21(1):2329. doi: 10.1186/s12889-021-12105-9.
BACKGROUND
Health insurance was considered as the third global health transition which can increase access to health care services by eliminating monetary obstacles to maternal health care use, particularly in emerging nations. Hence, this study aimed to assess the association between health insurance enrolment and maternal health care service utilization among women in Ethiopia.
METHODS
A cross-sectional study was conducted using the 2016 Ethiopia Demographic and Health Survey (EDHS) data set. About 4278 mothers who had delivered at least one child in the last five years of the survey were selected in the study. Multivariate logistic regression analysis was performed to measure the relationship between health insurance enrolment and maternal health care service utilization by controlling confounders An adjusted odds ratio with a 95% confidence interval and p-values < 0.05 were well-thought-out to state the imperative association.
RESULTS
The overall health insurance coverage among the women was 4.7%. About, 18.1% of women from households in the poorest wealth quantile had no health insurance coverage for maternal health care services. Moreover, 84% of women lived in a rural area did not enclose by health insurance. According to multivariate logistic regression, the likelihoods of ANC utilization were 1.54 times (AOR: 1.54; 95% CI: 1.06-2.25) higher among mothers who were enrolled in health insurance compared to their counterparts. In the same vein, the likelihoods of been attended by a skilled birth attendant were 1.84 times (AOR: 1.84; 95% CI: 1.1-3.08) higher among mothers who were enrolled in health insurance.
CONCLUSIONS
This study has shown that women enrolled in health insurance were associated with skilled delivery and recommended ANC utilization than women who did not enroll in health insurance. Health insurance enrolment enterprises must be available to all pregnant women, particularly those of poorer socioeconomic rank.
背景
健康保险被认为是全球第三次卫生转型，它可以通过消除获得妇幼保健服务的货币障碍，特别是在新兴国家，来增加获得卫生保健服务的机会。因此，本研究旨在评估埃塞俄比亚妇女参加健康保险与利用妇幼保健服务之间的关系。
方法
本研究采用 2016 年埃塞俄比亚人口与健康调查（EDHS）数据集进行了一项横断面研究。在研究中，选择了在调查过去五年中至少生育过一个孩子的 4278 名母亲。通过控制混杂因素，采用多变量逻辑回归分析来衡量健康保险参保与妇幼保健服务利用之间的关系。采用调整后的优势比（aOR）和 95%置信区间（CI）和 p 值<0.05 来表示重要关联。
结果
妇女的总体健康保险覆盖率为 4.7%。最贫穷财富阶层家庭中约有 18.1%的妇女没有健康保险来支付孕产妇保健服务费用。此外，84%居住在农村地区的妇女没有参加健康保险。根据多变量逻辑回归，与未参加健康保险的母亲相比，参加健康保险的母亲利用 ANC 的可能性高 1.54 倍（AOR：1.54；95%CI：1.06-2.25）。同样，与未参加健康保险的母亲相比，由熟练助产士接生的可能性高 1.84 倍（AOR：1.84；95%CI：1.1-3.08）。
结论
本研究表明，参加健康保险的妇女与熟练分娩和推荐的 ANC 利用有关，而未参加健康保险的妇女则没有。必须向所有孕妇，特别是社会经济地位较低的孕妇提供健康保险。
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