Symbiosis Centre for Management Studies, Symbiosis International Deemed University, Noida.
Afr J Prim Health Care Fam Med. 2024 Jan 21;16(1):e1-e6. doi: 10.4102/phcfm.v16i1.4056.
Nigeria has the highest maternal mortality rate among sub-Saharan African countries. Recently, universal health insurance coverage has been embraced as a means to enhance population health in low- and middle-income countries. Hitherto, the effect of health insurance coverage on the utilisation of facility-level delivery is largely unknown in the face of the earnest need to lower maternal mortality rates in developing countries.
To empirically investigate the association of health insurance coverage on health services utilisation of facility-level delivery and the extent to which public- and private-sector facility delivery in Nigeria had a disproportionate associational effect with health insurance coverage, in the universal health coverage era.
A cross-sectional study conducted for Nigeria.
This study employed a quasi-experimental method using propensity scores along with different matching methods that were applied to the most recent wave of Nigeria's Demographic and Health Survey (2020) data.
Evidence suggests that childbearing mothers from insured households had an average of 25% probability of utilising facility-level delivery relative to mothers from uninsured households in the year that preceded the survey. Moreover, private-sector facility delivery had a 31% higher associational effect with health insurance coverage than public-sector facility delivery, which had an estimated probability of 21%.
Expansion of health insurance coverage in Nigeria will be a desirable way to stimulate the utilisation of facility-level delivery by women of childbearing age. Consequently, coverage expansion has the potential to save many maternal and newborn lives in Nigeria.Contribution: This study has contributed to the urgent attention of the federal government of Nigeria to monitor and revamp the health insurance coverage policies of the country for better facilitation of health services to the Nigerian population.
尼日利亚是撒哈拉以南非洲国家中孕产妇死亡率最高的国家。最近，全民健康保险覆盖范围已被视为提高中低收入国家人口健康水平的一种手段。然而，在发展中国家迫切需要降低孕产妇死亡率的情况下，健康保险覆盖范围对设施层面分娩利用的影响在很大程度上仍不为人知。
在全民健康保险覆盖时代，实证研究健康保险覆盖范围对设施层面分娩服务利用的影响，以及尼日利亚公共和私营部门设施分娩与健康保险覆盖范围之间存在不成比例关联的程度。
在尼日利亚进行的一项横断面研究。
本研究采用了准实验方法，使用倾向评分以及不同的匹配方法，应用于尼日利亚最近一次人口与健康调查（2020 年）数据。
有证据表明，与调查前一年没有保险的家庭相比，有保险的家庭的生育母亲利用设施层面分娩的平均概率为 25%。此外，与公共部门设施分娩相比，私营部门设施分娩与健康保险覆盖范围的关联效应高出 31%，估计概率为 21%。
尼日利亚健康保险覆盖范围的扩大将是刺激育龄妇女利用设施层面分娩的一种理想方式。因此，覆盖范围的扩大有可能在尼日利亚挽救许多母婴生命。
本研究引起了尼日利亚联邦政府对监测和改革国家健康保险覆盖政策的紧急关注，以更好地为尼日利亚人民提供医疗服务。
