Senior M&E Advisor, John Snow, Inc. Arlington, VA22202.
Senior Research, Monitoring, and Evaluation Advisor John Snow Inc.Arlington, VA22202.
J Biosoc Sci. 2024 Jan;56(1):104-124. doi: 10.1017/S0021932023000032. Epub 2023 Feb 28.
The effect of health insurance coverage on sexual and reproductive health, especially unintended pregnancy, has scantly been researched. Using the 2014 Ghana Demographic and Health Survey, the study examined the links between women's health insurance enrolment on unintended pregnancy in Ghana.
The sample consisted of 9,396 women aged 15-49 years, but the analysis was limited to the 4,544 women who were pregnant in the two years preceding the survey. The effects of health insurance enrolment on unintended pregnancy was examined with the propensity score matching. The health insurance enrolment was the treatment variable and unintended pregnancy as the outcome variable.
This study showed that 66.0% of all women surveyed had health insurance coverage and 31.8% of all women of childbearing age who were currently or had previously been pregnant reported having at least one unintended pregnancy. Thirty percent of insured women had an unintended pregnancy, compared to 37% of uninsured women. The results showed that education, household wealth index, religion, and type of marital union were significant predictor of health insurance coverage among Ghanaian women. The PSM split the women based on their health insurance status. After matching, the difference between the insured and uninsured women reduces significantly. Results demonstrated that, the probability of unintended pregnancy was 0.312 among insured women and 0.351 among those not insured in Ghana. This implies that having health insurance coverage will help in reducing the likelihood of women experiencing unintended pregnancy.
Results highlight the importance of the target of universal health coverage under the sustainable development goal 3 and demonstrate that expanding existing health insurance schemes within Ghana could contribute to reducing the number unintended pregnancies experienced each year.
健康保险覆盖范围对性健康和生殖健康的影响，特别是意外怀孕，研究甚少。本研究利用 2014 年加纳人口与健康调查，考察了加纳女性健康保险参保与意外怀孕之间的关系。
样本包括 9396 名 15-49 岁的女性，但分析仅限于在调查前两年怀孕的 4544 名女性。采用倾向评分匹配法研究健康保险参保对意外怀孕的影响。健康保险参保是处理变量，意外怀孕是结果变量。
本研究表明，调查的所有女性中，有 66.0%有健康保险覆盖，在所有处于生育年龄且目前或曾经怀孕的女性中，有 31.8%报告至少有一次意外怀孕。30%的参保女性有意外怀孕，而未参保女性为 37%。结果表明，教育、家庭财富指数、宗教和婚姻类型是加纳女性健康保险覆盖的重要预测因素。PSM 根据健康保险状况将女性分开。匹配后，参保和未参保女性之间的差异显著降低。结果表明，参保女性意外怀孕的概率为 0.312，未参保女性为 0.351。这意味着拥有健康保险可以帮助降低女性意外怀孕的可能性。
结果强调了可持续发展目标 3 下全民健康覆盖目标的重要性，并表明在加纳扩大现有健康保险计划可能有助于减少每年意外怀孕的数量。
