Abstract:
Background:Access to quality obstetric care is considered essential to reducing maternal and new-born mortality. We evaluated the effect of the introduction of a multifaceted voluntary health insurance programme on hospital deliveries in rural Nigeria. Methods:We used an interrupted time-series design, including a control group. The intervention consisted of providing voluntary health insurance covering primary and secondary healthcare, including antenatal and obstetric care, combined with improving the quality of healthcare facilities. We compared changes in hospital deliveries from 1 May 2005 to 30 April 2013 between the programme area and control area in a difference-in-differences analysis with multiple time periods, adjusting for observed confounders. Data were collected through household surveys. Eligible households ( n = 1500) were selected from a stratified probability sample of enumeration areas. All deliveries during the 4-year baseline period ( n = 460) and 4-year follow-up period ( n = 380) were included. Findings:Insurance coverage increased from 0% before the insurance was introduced to 70.2% in April 2013 in the programme area. In the control area insurance coverage remained 0% between May 2005 and April 2013. Although hospital deliveries followed a common stable trend over the 4 pre-programme years ( P = 0.89), the increase in hospital deliveries during the 4-year follow-up period in the programme area was 29.3 percentage points (95% CI: 16.1 to 42.6; P < 0.001) greater than the change in the control area (intention-to-treat impact), corresponding to a relative increase in hospital deliveries of 62%. Women who did not enroll in health insurance but who could make use of the upgraded care delivered significantly more often in a hospital during the follow-up period than women living in the control area ( P = 0.04). Conclusions:Voluntary health insurance combined with quality healthcare services is highly effective in increasing hospital deliveries in rural Nigeria, by improving access to healthcare for insured and uninsured women in the programme area.
journal_name
Health Policy Planjournal_title
Health policy and planningauthors
Brals D,Aderibigbe SA,Wit FW,van Ophem JCM,van der List M,Osagbemi GK,Hendriks ME,Akande TM,Boele van Hensbroek M,Schultsz Cdoi
10.1093/heapol/czx034subject
Has Abstractpub_date
2017-09-01 00:00:00pages
990-1001issue
7eissn
0268-1080issn
1460-2237pii
3591826journal_volume
32pub_type
杂志文章abstract::In August 2003, the Ghanaian Government made history by implementing the first National Health Insurance System (NHIS) in sub-Saharan Africa. Within 2 years, over one-third of the country had voluntarily enrolled in the NHIS. To discourage households from selectively enrolling their sickest (high-risk) members, the NH...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czr057
更新日期:2012-08-01 00:00:00
abstract::BACKGROUND Post-communist health care reforms and the break-up of Czechoslovakia have been studied from various perspectives, but little research has addressed the impact on health system performance. This paper investigates the quality and performance of the Slovak and Czech health systems before and after 1989, incl...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czs093
更新日期:2013-08-01 00:00:00
abstract::The Syrian conflict has caused enormous displacement of a population with a high non-communicable disease (NCD) burden into surrounding countries, overwhelming health systems' NCD care capacity. Médecins sans Frontières (MSF) developed a primary-level NCD programme, serving Syrian refugees and the host population in I...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czaa050
更新日期:2020-10-01 00:00:00
abstract::Hypertension and diabetes are highly prevalent in China and pose significant health and economic burdens, but large gaps in care remain for people with such conditions. In this article, drawing on administrative insurance claim data from China's Urban Employee Basic Medical Insurance (UEBMI), we use an interrupted tim...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czaa087
更新日期:2020-10-01 00:00:00
abstract:OBJECTIVE:To estimate the cost-effectiveness of introducing hepatitis B vaccine into routine infant immunization services in Mozambique, which took place in the year 2001. METHODS:A decision analytic model was used to estimate the impact of hepatitis B vaccination. This model was developed for the WHO to estimate the ...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czi006
更新日期:2005-01-01 00:00:00
abstract::Zambia has one of the most liberal abortion laws in sub-Saharan Africa. However, rates of unsafe abortion remain high with negative health and economic consequences. Little is known about the economic burden on women of abortion care-seeking in low income countries. The majority of studies focus on direct costs (e.g. ...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czv138
更新日期:2016-09-01 00:00:00
abstract::'One World, One Health' has become a key rallying theme for the integration of public health and animal health priorities, particularly in the governance of pandemic-scale zoonotic infectious disease threats. However, the policy challenges of integrating public health and animal health priorities in the context of tra...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czu001
更新日期:2015-03-01 00:00:00
abstract::Advocacy, policy, research and intervention efforts against childhood pneumonia have lagged behind other health issues, including malaria, measles and tuberculosis. Accelerating progress on the issue began in 2008, following decades of efforts by individuals and organizations to address the leading cause of childhood ...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czv070
更新日期:2016-04-01 00:00:00
abstract::Poor mental health is a pressing global health problem, with high prevalence among poor populations from low-income countries. Existing studies of conditional cash transfer (CCT) effects on mental health have found positive effects. However, there is a gap in the literature on population-wide effects of cash transfers...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czaa079
更新日期:2020-11-20 00:00:00
abstract::Measuring and tracking the quality of healthcare is a critical part of improving service delivery, clinic efficiency and health outcomes. However, no standardized or widely accepted tool exists to assess the quality of clinic-based family planning services in low- and middle-income countries. The objective of this lit...
journal_title:Health policy and planning
pub_type: 杂志文章,评审
doi:10.1093/heapol/czw123
更新日期:2017-03-01 00:00:00
abstract::Since 2001 substantial resources have been allocated to the reproductive, maternal, newborn and child health sector (RMNCH) in Pakistan. Many new programmes have been started and coverage of some existing programmes has been extended to un-served and rural areas. Despite these efforts the Millennium Development Goals ...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czx021
更新日期:2017-07-01 00:00:00
abstract::Low contract renewal rates have been identified as one of the challenges facing the development of community-based health insurance (CBHI) schemes. This article uses longitudinal household survey data gathered in 2012 and 2013 to examine dropout in the case of Ethiopia's pilot CBHI scheme. We treat dropout as a functi...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czu142
更新日期:2015-12-01 00:00:00
abstract::Ensuring financial access to health services is a critical challenge for poor countries if they are to reach the health Millennium Development Goals (MDGs). This article examines the case of Rwanda, a country which has championed innovative health care financing policies. Between 2000 and 2007, Rwanda has improved fin...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czr070
更新日期:2011-11-01 00:00:00
abstract::The burden of disease due to injuries has elicited virtually no public health response in the countries of central and eastern Europe, even though injuries have long been a much greater problem in the east of Europe than in the west, with children especially affected. This paper seeks to identify factors that have inh...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/15.3.263
更新日期:2000-09-01 00:00:00
abstract::It is generally assumed by the donor community that the targeted funding of global, regional or cross-border surveillance programmes is an efficient way to support resource-poor countries in developing their own national public health surveillance infrastructure, to encourage national authorities to share outbreak int...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czl035
更新日期:2007-01-01 00:00:00
abstract::Many countries in sub-Saharan Africa face the problem of organizing health service delivery in a manner that provides adequate quality and coverage of health care to their populations against a background of economic recession and limited resources. In response to these challenges, different governments, including tha...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/14.1.59
更新日期:1999-03-01 00:00:00
abstract::Integration of health services has been pursued worldwide. Diversity in integration approaches and in the contexts in which integrated programmes operate, however, hinders comparative analysis of care integration in both high-income countries (HICs) and low- and middle-income countries (LMICs). This study evaluates an...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czz111
更新日期:2019-11-01 00:00:00
abstract::This paper explores the nature and type of policy transfer promoted by global health partnerships to facilitate access to medication in Cameroon and the associated implementation challenges. Using concepts from policy transfer, multi-level governance and the politics of scale, the paper conceptualizes the social space...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czq018
更新日期:2011-01-01 00:00:00
abstract::There has been increased interest in and experimentation with demand-side mechanisms such as the use of vouchers that place purchasing power in the hands of targeted consumers to improve the uptake of healthcare services in low-income settings. A key measure of the success of such interventions is the extent to which ...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czt079
更新日期:2014-07-01 00:00:00
abstract::This paper provides guidance on how to do a stakeholder analysis, whether the aim is to conduct a policy analysis, predict policy development, implement a specific policy or project, or obtain an organizational advantage in one's dealings with other stakeholders. Using lessons learned from an analysis of alcohol polic...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/15.3.338
更新日期:2000-09-01 00:00:00
abstract:BACKGROUND:One billion children live in war-affected regions of the world. We conducted the first cost-effectiveness analysis of an intervention for war-affected youth in sub-Saharan Africa, as well as a broader cost analysis. METHODS:The Youth Readiness Intervention (YRI) is a behavioural treatment for reducing funct...
journal_title:Health policy and planning
pub_type: 杂志文章,随机对照试验
doi:10.1093/heapol/czv078
更新日期:2016-05-01 00:00:00
abstract:OBJECTIVE:To determine whether an expansion in private sector contraceptive supply is associated with increased socio-economic inequality in the modern contraceptive prevalence rate (MCPR inequality). METHODS:Multiple rounds of Demographic and Health Surveys data were analysed for five countries that experienced an in...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czn035
更新日期:2008-11-01 00:00:00
abstract::Home visiting programmes are increasingly recognized as one of the most effective interventions to improve child health and development in low-income settings. However, the best platforms to deliver such programmes remain unclear. We conducted a randomized controlled trial to test the relative effectiveness of child d...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czaa195
更新日期:2021-01-26 00:00:00
abstract::Contracting non-governmental organizations (NGOs) has been shown to increase health service delivery output considerably over relatively short time frames in low-income countries, especially when applying performance-related pay as a stimulus. A key concern is how to manage the transition back to government-operated s...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czp049
更新日期:2010-05-01 00:00:00
abstract::In Vietnam, as in many other countries, tuberculosis (TB) control has long been organized exclusively within the public health-care system. However, recently the private health-care sector has become more important and private health-care providers currently have a role in TB care delivery in Vietnam. Through a retros...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/16.1.47
更新日期:2001-03-01 00:00:00
abstract::Contributing to the ongoing debate about policy feedback in comparative public policy research, this article examines the evolution of healthcare financing policy in Ghana. More specifically, this article investigates the shift in healthcare financing from full cost recovery, known as 'cash-and-carry', to a nation-wid...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czaa080
更新日期:2020-11-20 00:00:00
abstract::Scarce evidence exists on the features, determinants and implications of physicians' dual practice, especially in resource-poor settings. This study considered dual practice patterns in three African cities and the respective markets for physician services, with the objective of understanding the influence of local de...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czt071
更新日期:2014-09-01 00:00:00
abstract::Although many public hospital physicians in Vietnam offer private service on the side, little is known about the magnitude and nature of the phenomenon so-called dual practice, let alone the dynamics between the public and private health sectors. This study investigates how and to what degree public hospital physician...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czy075
更新日期:2018-10-01 00:00:00
abstract::Although the number of direct Ebola-related deaths from the 2013 to 2016 West African Ebola outbreak has been quantified, the number of indirect deaths, resulting from decreased utilization of routine health services, remains unknown. Such information is a key ingredient of health system resilience, essential for adeq...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czx108
更新日期:2017-11-01 00:00:00
abstract::This study examines the factors that influence patient choice of medical provider in the three-tier health care system in rural China: village health posts, township health centres, and county (and higher level) hospitals. The model is estimated using a multinomial logit approach applied to a sample of 1877 cases of o...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/13.3.311
更新日期:1998-09-01 00:00:00