Determinants of health insurance coverage among women aged 15-49 years in Uganda

Abstract

This study investigated the determinants of health insurance coverage among women of reproductive age in Uganda. The study specifically examined the individual, household as well as community factors associated with uptake of health insurance among the women. The analysis was conducted on all (18,506) women of reproductive age from whom the data was collected during the 2016 Uganda Demographic and Health survey. The Pearson Chi-square test was used to test the association between selected characteristics and health insurance coverage among the women. The complementary log-log regression model was used to examine the net-effect of selected characteristics on the uptake of health insurance by the women. The findings indicate that the prevalence of health insurance among women aged 15-49 years in Uganda is very low at only 1.4%. The findings further indicate that health insurance coverage was positively associated with; being older than 29 years, coming from Kigezi region and access to mass media. Being Born-again or from the Muslim religious sect, having a husband/partner in the agricultural and the skilled manual professions, being from Teso region of residence, whether getting money for treatment is a big problem and being employed in the skilled manual profession were negatively associated with health insurance coverage. It is important to increase health insurance coverage for all women of reproductive age so that there is improved access to health services and care including reproductive health. To achieve this, there is need to strengthen existing health insurance schemes and to fast-track the proposed national health insurance scheme in Uganda so as to reap the reproductive health benefits of health insurance which have been documented in several studies such as one in south western Uganda. Increased sensitization through mass media about the benefits of health insurance, available options and the affordability of the schemes will be key to reducing inequality in access to quality reproductive health services such as those related to maternal and child health in Uganda. The health insurance service providers should target people of all occupations, wealth categories, regions like Karamoja and women who have ever given birth with affordable products such that they can enroll.