Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, P. O. Box, L.G. 13, Legon, Ghana.
34 Military Hospital, Wilberforce, Freetown, Sierra Leone.
BMC Health Serv Res. 2022 Feb 28;22(1):269. doi: 10.1186/s12913-022-07670-7.
Health insurance enrolment provides financial access to health care and reduces the risk of catastrophic healthcare expenditure. Therefore, the objective of this study was to assess the prevalence and correlates of health insurance enrolment among Ghanaian children under five years.
We analysed secondary data from the 2017/18 Ghana Multiple Indicator Cluster Survey. The survey was a nationally representative weighted sample comprising 8,874 children under five years and employed Computer Assisted Personal Interviewing to collect data from the participants. In addition, Chi-square and Logistic Regression analyses were conducted to determine factors associated with health insurance enrolment.
The results showed that a majority (58.4%) of the participants were insured. Health insurance enrollment was associated with child age, maternal educational status, wealth index, place of residence and geographical region (p < 0.05). Children born to mothers with higher educational status (AOR = 2.14; 95% CI: 1.39-3.30) and mothers in the richest wealth quintile (AOR = 2.82; 95% CI: 2.00-3.98) had a higher likelihood of being insured compared with their counterparts. Also, children residing in rural areas (AOR = 0.75; 95% CI: 0.61-0.91) were less likely to be insured than children in urban areas.
This study revealed that more than half of the participants were insured. Health insurance enrolment was influenced by the child's age, mother's educational status, wealth index, residence, ethnicity and geographical region. Therefore, interventions aimed at increasing health insurance coverage among children should focus on children from low socio-economic backgrounds. Stakeholders can leverage these findings to help improve health insurance coverage among Ghanaian children under five years.
健康保险的参保可以为医疗保健提供经济支持，并降低灾难性医疗支出的风险。因此，本研究的目的是评估加纳 5 岁以下儿童参保的流行率和相关因素。
我们分析了 2017/18 年加纳多指标类集调查的二级数据。该调查是一个全国代表性的加权样本，包括 8874 名 5 岁以下儿童，采用计算机辅助个人访谈从参与者那里收集数据。此外，还进行了卡方检验和逻辑回归分析，以确定与健康保险参保相关的因素。
结果显示，大多数（58.4%）参与者都参保了。健康保险参保与儿童年龄、母亲教育程度、财富指数、居住地和地理位置有关（p<0.05）。母亲教育程度较高（AOR=2.14；95%CI：1.39-3.30）和最富有五分位数（AOR=2.82；95%CI：2.00-3.98）的儿童，比同龄人更有可能参保。此外，居住在农村地区（AOR=0.75；95%CI：0.61-0.91）的儿童，比居住在城市地区的儿童更不可能参保。
本研究表明，超过一半的参与者参保了。健康保险参保受儿童年龄、母亲教育程度、财富指数、居住地、族裔和地理位置的影响。因此，旨在提高儿童健康保险覆盖率的干预措施应重点关注社会经济背景较低的儿童。利益相关者可以利用这些发现，帮助提高加纳 5 岁以下儿童的健康保险覆盖率。
