Effect of health insurance on utilisation of maternal health care services in Uganda

Abstract

BACKGROUND

Although the maternal mortality ratio in Uganda declined from 505 to 336 maternal death per 100,000 live births between 2001 and 2016, it is still far above the Sustainable Development Goal target of 70 by 2030. This study sought to examine the effect of health insurance on the utilisation of maternal health care services in Uganda.

MATERIALS AND METHODS

Using data from the 2016 Uganda Demographic Health Survey, the chi-square test and trivariate probit regression model were employed for analysis. The study used a descriptive design, and a sample of 20,291 households was selected using cluster sampling. Women aged between 15 and 49 years were then identified. Out of the 19,088 eligible women identified, 18,506 women were successfully interviewed, giving a response rate of 97%.

RESULTS

Almost 60% of mothers had at least four antenatal care (ANC) visits, 75% of the mothers delivered at a health facility and 54% of the mothers received postnatal care within two days after delivery. Health insurance increased the probability of utilising ANC and delivering at a health facility by 0.30 and 0.28, respectively. Also, the level of education, birth order, wealth index, fertility risk, and region influenced the use of ANC and delivery at a health facility. In contrast, delivery at a health facility positively influenced the utilisation of early postnatal care.

CONCLUSION

Even with low health insurance coverage, private health insurance had a significant positive effect on utilising maternal health care services. Therefore, establishing a national health insurance program is necessary to improve maternal healthcare utilisation.