School of Public Health, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
Front Public Health. 2023 Mar 30;11:1067773. doi: 10.3389/fpubh.2023.1067773. eCollection 2023.
Universal health coverage (UHC) is aimed at ensuring that everyone has access to high-quality healthcare without the risk of financial ruin. Community-based health insurance (CBHI) is one of the essential means to achieve the sustainable development goals (SDGs) global health priority of UHC. Thus, this study assessed health insurance enrollment and associated factors among reproductive age women in Ethiopia.
We computed the health insurance enrollment of reproductive-age women using secondary data from the recent Ethiopian Mini Demographic and Health Surveys (EMDHS) 2019. The EMDHS was a community-based cross-sectional study carried out in Ethiopia from March 21 to June 28, 2019. Cluster sampling with two stages was employed for the survey. The study comprised 8885 (weighted) reproductive-age women. STATA 14 was used for data processing and analysis. Bivariate and multivariable logistic regression analyses were conducted. Adjusted odds ratio (AOR) with 95% confidence interval (CI) was reported and statistical significance was set at a value of < 0.05.
Of the 8,885 study participants, 3,835 (43.2, 95% CI; 42.1, 44.2%) of women had health insurance. Women aged 20-24 years, 25-29 years, and 30-34 years less likely to enroll in health insurance compared to their younger counterparts (15-19 years). Women living in rural areas, had greater than five family sizes, living with a female household head, and having more than five living children were negatively associated with enrollment in health insurance. Besides, health insurance enrollment among reproductive-age women is significantly affected by region and religious variation.
The overall CBHI enrolment among reproductive-age women in Ethiopia was low. To achieve the SDGs of reducing maternal mortality ratio and neonatal mortality, improving reproductive-age women's access to health insurance is essential. The national, regional, and local officals, policymakers, NGOs, program planners, and other supporting organizations working on improving health insurance enrollment of reproductive age women need to create awareness and support them based on these significant factors.
全民健康覆盖（UHC）旨在确保每个人都能获得高质量的医疗保健，而不会有财务破产的风险。社区为基础的健康保险（CBHI）是实现可持续发展目标（SDGs）全球健康优先事项全民健康覆盖的重要手段之一。因此，本研究评估了埃塞俄比亚育龄妇女的健康保险参保情况及其相关因素。
我们使用最近的埃塞俄比亚微型人口与健康调查（EMDHS）2019 的二级数据计算了育龄妇女的健康保险参保情况。EMDHS 是一项于 2019 年 3 月 21 日至 6 月 28 日在埃塞俄比亚进行的基于社区的横断面研究。采用两阶段的聚类抽样进行调查。研究包括 8885 名（加权）育龄妇女。使用 STATA 14 进行数据处理和分析。进行了双变量和多变量逻辑回归分析。报告了调整后的优势比（AOR）和 95%置信区间（CI），并将统计学意义设定为 < 0.05。
在 8885 名研究参与者中，3835 名（43.2%，95%CI；42.1%，44.2%）妇女参加了健康保险。与年龄较小的妇女相比，20-24 岁、25-29 岁和 30-34 岁的妇女不太可能参加健康保险。居住在农村地区、家庭规模大于五人、与女性户主同住和有五个以上活产子女的妇女，参加健康保险的可能性较低。此外，育龄妇女的健康保险参保情况因区域和宗教差异而显著不同。
埃塞俄比亚育龄妇女的总体 CBHI 参保率较低。为了实现可持续发展目标降低孕产妇死亡率和新生儿死亡率，提高育龄妇女获得健康保险的机会至关重要。国家、地区和地方官员、政策制定者、非政府组织、项目规划者和其他支持组织需要根据这些重要因素提高育龄妇女的健康保险参保意识并为其提供支持。
