The DHS Program

Health Insurance Coverage and Access to Maternal Health Services: Findings from Nigerian Women of Reproductive Age (English) 

Document Type

Working Papers

Publication Topic(s)

Maternal Health, Maternal Mortality

Country(s)

Nigeria

Language

English

Recommended Citation

Esan, O.T., A.A. Adeomi, and O.T. Afolabi. 2023. Health Insurance Coverage and Access to Maternal Health Services: Findings from Nigerian Women of Reproductive Age. DHS Working Papers No. 192. Rockville, Maryland, USA: ICF.

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Publication Date

July 2023

Publication ID

WP192

Abstract:

Background: Inequitable financial access to maternal health services (MHS) has contributed to maternal deaths, especially in low- and middle-income countries. Evidence in the literature on women’s health insurance status and access to MHS in Nigeria is sparse. This study examined the association between health insurance coverage and access to MHS among Nigerian women of reproductive age. Methods: This is a cross-sectional study that used the 2018 Nigeria Demographic Health Survey (NDHS). A total of 12,935 women who had their last delivery within 2 years of the NDHS were included in the study. Access to MHS was assessed by using the number of antenatal clinic (ANC) visits and health facility delivery. Adjusted logistic regression models were fit to control for individual, household, and community level factors. Results: Only 18.5% and 40.6% of the women in the study attended =8 ANC visits and delivered in a health facility, respectively. About 40.0% of women who had =8 ANC visits and 71.8% of those who delivered in health facilities had health insurance coverage. There were statistically significant associations between having health insurance and attendance of =8 ANC visits (aOR = 1.9, 95% CI [1.26 – 2.95]) and women delivering at a health facility (aOR = 2.0, 95% CI [1.39 – 2.82]). Conclusion: There was a low uptake of health insurance programs among the Nigerian women in this study. Having health insurance coverage was significantly associated with =8 ANC visits and women delivering in health facilities. Thus, providing health insurance may be an important way to improve women’s access to MHS in Nigeria.