Faculty of Humanities, North West University, Mmabatho 2745, South Africa.
Int J Environ Res Public Health. 2022 Feb 4;19(3):1766. doi: 10.3390/ijerph19031766.
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. 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 < 0.05. 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, < 0.05; Model II: OR: 1.34; 95% CI: 0.28-1.42, < 0.05) and in South Africa (Model I: OR: 1.33; 95% CI: 0.16-1.66, < 0.05; Model II: OR: 1.76; 95% CI: 0.34-1.82, < 0.05). Respondents with a higher wealth index and who were employed were independently associated with health insurance uptake in Nigeria and South Africa ( < 0.001). Females were more likely to be insured ( < 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. 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.
核心的全民健康覆盖（UHC）目标是通过减少各种形式的不平等，确保所有人都能获得医疗保健服务。然而，在尼日利亚和南非等国家，财务限制是获得医疗保健的主要障碍。本研究的结果可能有助于为南非和尼日利亚提供信息和沟通卫生政策，以增加获得医疗保健的机会并提高其利用率。在研究背景选择方面，尼日利亚-南非双边关系在政治、经济和贸易方面得到了证明。本研究的目的是估计医疗保险覆盖的流行率，并探讨与南非和尼日利亚医疗保险相关的社会人口因素。这是一项使用 2018 年尼日利亚人口与健康调查和 2016 年南非人口与健康调查的横断面研究。使用 2018 年尼日利亚人口与健康调查中 55132 个人的数据和 2016 年南非人口与健康调查中 12142 个人的数据，调查与社会人口因素相关的医疗保险流行率。采用百分比、频率、卡方检验和多变量逻辑回归，显著性水平为 < 0.05。尼日利亚人口中有 2.8%，南非人口中有 13.3%的人有保险（尼日利亚：男性 3.4%，女性 2.7%与南非：男性 13.9%，女性 12.8%）。多变量逻辑回归分析显示，在尼日利亚（模型 I：OR：1.43；95%CI：0.34-1.54，< 0.05；模型 II：OR：1.34；95%CI：0.28-1.42，< 0.05）和南非（模型 I：OR：1.33；95%CI：0.16-1.66，< 0.05；模型 II：OR：1.76；95%CI：0.34-1.82，< 0.05），较高的教育程度与医疗保险显著相关，独立于其他社会人口因素。在尼日利亚和南非，较高的财富指数和就业的受访者独立地与医疗保险的使用相关（< 0.001）。与男性相比，两国的女性更有可能获得保险（< 0.001），而且在尼日利亚和南非，教育对高财富指数家庭中男性和女性的医疗保险使用意愿有显著影响。两国的医疗保险覆盖率都很低，与教育、财富和就业等社会人口因素独立相关。两国都需要持续开展宣传、教育健康干预和就业机会，让两国公民都能参与到广泛的医疗保险覆盖中来。
