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Understanding variations in health insurance coverage in Ghana, Kenya, Nigeria, and Tanzania: Evidence from demographic and health surveys

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  • Hubert Amu
  • Kwamena Sekyi Dickson
  • Akwasi Kumi-Kyereme
  • Eugene Kofuor Maafo Darteh

Abstract

Background: Realisation of universal health coverage is not possible without health financing systems that ensure financial risk protection. To ensure this, some African countries have instituted health insurance schemes as venues for ensuring universal access to health care for their populace. In this paper, we examined variations in health insurance coverage in Ghana, Kenya, Nigeria, and Tanzania. Methods: We used data from demographic and health surveys of Ghana (2014), Kenya (2014), Nigeria (2013), and Tanzania (2015). Women aged 15–49 and men aged 15–59 years were included in the study. Our study population comprised 9,378 women and 4,371 men from Ghana, 14,656 women and 12,712 men from Kenya, 38,598 women and 17,185 men from Nigeria, and 10,123 women and 2,514 men from Tanzania. Bivariate and multivariate techniques were used to analyse the data. Results: Coverage was highest in Ghana (Females = 62.4%, Males = 49.1%) and lowest in Nigeria (Females = 1.1%, Males = 3.1%). Age, level of education, residence, wealth status, and occupation were the socio-economic factors influencing variations in health insurance coverage. Conclusions: There are variations in health insurance coverage in Ghana, Kenya, Nigeria, and Tanzania, with Ghana recording the highest coverage. Kenya, Tanzania, and Nigeria may not be able to achieve universal health coverage and meet the sustainable development goals on health by the year 2030 if the current fragmented public health insurance systems persist in those countries. Therefore, the various schemes of these countries should be harmonised to help maximise the size of their risk pools and increase the confidence of potential subscribers in the systems, which may encourage them to enrol.

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  • Hubert Amu & Kwamena Sekyi Dickson & Akwasi Kumi-Kyereme & Eugene Kofuor Maafo Darteh, 2018. "Understanding variations in health insurance coverage in Ghana, Kenya, Nigeria, and Tanzania: Evidence from demographic and health surveys," PLOS ONE, Public Library of Science, vol. 13(8), pages 1-14, August.
    • Handle: RePEc:plo:pone00:0201833
    DOI: 10.1371/journal.pone.0201833
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    References listed on IDEAS

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    1. Kwame Adjei-Mantey & Charles Yuji Horioka, 2023. "Determinants of health insurance enrollment and health expenditure in Ghana: an empirical analysis," Review of Economics of the Household, Springer, vol. 21(4), pages 1269-1288, December.
    2. Roosa Lambin & Milla Nyyssölä, 2022. "Two decades of Tanzanian health policy: Examining policy developments and opportunities through a gender lens," WIDER Working Paper Series wp-2022-30, World Institute for Development Economic Research (UNU-WIDER).
    3. Osei Afriyie, Doris & Masiye, Felix & Tediosi, Fabrizio & Fink, Günther, 2023. "Confidence in the health system and health insurance enrollment among the informal sector population in Lusaka, Zambia," Social Science & Medicine, Elsevier, vol. 321(C).
    4. Hubert Amu & Abdul-Aziz Seidu & Ebenezer Agbaglo & Robert Kokou Dowou & Edward Kwabena Ameyaw & Bright Opoku Ahinkorah & Kwaku Kissah-Korsah, 2021. "Mixed effects analysis of factors associated with health insurance coverage among women in sub-Saharan Africa," PLOS ONE, Public Library of Science, vol. 16(3), pages 1-15, March.
    5. Armand Zimmerman & Samara Fox & Randi Griffin & Taylor Nelp & Erika Bárbara Abreu Fonseca Thomaz & Mark Mvungi & Blandina T Mmbaga & Francis Sakita & Charles J Gerardo & Joao Ricardo Nickenig Vissoci , 2020. "An analysis of emergency care delays experienced by traumatic brain injury patients presenting to a regional referral hospital in a low-income country," PLOS ONE, Public Library of Science, vol. 15(10), pages 1-16, October.
    6. Hubert Amu & Kwamena Sekyi Dickson & Kenneth Setorwu Adde & Kwaku Kissah-Korsah & Eugene Kofuor Maafo Darteh & Akwasi Kumi-Kyereme, 2022. "Prevalence and factors associated with health insurance coverage in urban sub-Saharan Africa: Multilevel analyses of demographic and health survey data," PLOS ONE, Public Library of Science, vol. 17(3), pages 1-14, March.
    7. Sunday A. Adebisi & Joyce M.Odiachi & Ngozi A. Chikere, 2019. "The National Health Insurance Scheme (NHIS) in Nigeria: Has the Policy Achieved its Intended Objectives?," Academic Journal of Economic Studies, Faculty of Finance, Banking and Accountancy Bucharest,"Dimitrie Cantemir" Christian University Bucharest, vol. 5(3), pages 97-104, September.

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