Peer-reviewed article
Health insurance coverage and access to child and maternal health services in West Africa: a systematic scoping review
Joshua Dadjo, Olumuyiwa Omonaiye, Sanni Yaya ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5This is a systematic scoping review looking at whether health insurance improves access to health services for mothers and children in West Africa. The researchers reviewed 49 studies covering 51 different settings. They found that in most cases, having health insurance increased the use of maternal and child health services. Wealth and education also affected how much people could access care. The authors conclude that health insurance could be a useful long-term way to reduce the high rates of maternal and child deaths in the region.
Key points
- West Africa has some of the highest maternal and under-five mortality rates in the world
- 49 studies across 51 study settings were reviewed
- In most study settings, health insurance increased access to child and maternal health services
- Wealth and education were also important determinants of access to services
- The authors call for an equity-focused approach and more research on sustainable access to care
Limitations
As a scoping review, it summarizes existing studies of varying quality and designs rather than presenting new primary data, so it cannot establish a precise causal effect size of insurance on outcomes.
Abstract
Abstract Background According to the United Nations, the third Sustainable Development Goal, ‘Ensure Healthy Lives and Promote Well-Being at All Ages’, set numerous targets on child and maternal health. Universal health insurance is broadly seen as a solution to fulfil these targets. West Africa is known to have the most severe maternal mortality and under-five mortality rates in the world. This review seeks to understand whether health insurance provides increased access to services for mothers and children in this region. Methods The protocol for this review is registered in the International Prospective Register of Systematic Reviews database (CRD42020203859). A search was conducted in the MEDLINE Complete, Embase, CINAHL Complete and Global Health databases. Eligible studies were from West African countries. The population of interest was mothers and children and the outcome of interest was the impact of health insurance on access to services. Data were extracted using a standardized form. The primary outcome was the impact of health insurance on the rate of utilization and access to services. The Joanna Briggs Institute Critical Appraisal Tool was used for methodological assessment. Results Following screening, we retained 49 studies representing 51 study settings. In most study settings, health insurance increased access to child and maternal health services. Other determinants of access were socio-economic factors such as wealth and education. Conclusions Our findings suggest that health insurance may be a viable long-term strategy to alleviate West Africa's burden of high maternal and child mortality rates. An equity lens must guide future policy developments and significant research is needed to determine how to provide access reliably and sustainably to services for mothers and children in the near and long term.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Health insurance coverage for mothers and children
- Population
- Mothers and children in West African countries
Key finding
In most study settings, health insurance increased access to child and maternal health services
Dadjo et al. · Crossref · 23 Aug 2023