The effect of health insurance and health facility-upgrades on hospital deliveries in rural Nigeria: a controlled interrupted time-series study.

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 Plan

authors

Brals D,Aderibigbe SA,Wit FW,van Ophem JCM,van der List M,Osagbemi GK,Hendriks ME,Akande TM,Boele van Hensbroek M,Schultsz C

doi

10.1093/heapol/czx034

subject

Has Abstract

pub_date

2017-09-01 00:00:00

pages

990-1001

issue

7

eissn

0268-1080

issn

1460-2237

pii

3591826

journal_volume

32

pub_type

杂志文章
  • Does household enrolment reduce adverse selection in a voluntary health insurance system? Evidence from the Ghanaian National Health Insurance System.

    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

    authors: Rajkotia Y,Frick K

    更新日期:2012-08-01 00:00:00

  • 'Avoidable' mortality: a measure of health system performance in the Czech Republic and Slovakia between 1971 and 2008.

    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

    authors: Kossarova L,Holland W,Mossialos E

    更新日期:2013-08-01 00:00:00

  • Delivering a primary-level non-communicable disease programme for Syrian refugees and the host population in Jordan: a descriptive costing study.

    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

    authors: Ansbro É,Garry S,Karir V,Reddy A,Jobanputra K,Fardous T,Sadique Z

    更新日期:2020-10-01 00:00:00

  • The association between an increased reimbursement cap for chronic disease coverage and healthcare utilization in China: an interrupted time series study.

    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

    authors: Shen M,He W,Yeoh EK,Wu Y

    更新日期:2020-10-01 00:00:00

  • The cost-effectiveness of introducing hepatitis B vaccine into infant immunization services in Mozambique.

    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

    authors: Griffiths UK,Hutton G,Das Dores Pascoal E

    更新日期:2005-01-01 00:00:00

  • The individual level cost of pregnancy termination in Zambia: a comparison of safe and unsafe abortion.

    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

    authors: Leone T,Coast E,Parmar D,Vwalika B

    更新日期:2016-09-01 00:00:00

  • 'One health' and development priorities in resource-constrained countries: policy lessons from avian and pandemic influenza preparedness in Zambia.

    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

    authors: Mwacalimba KK,Green J

    更新日期:2015-03-01 00:00:00

  • Pneumonia's second wind? A case study of the global health network for childhood pneumonia.

    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

    authors: Berlan D

    更新日期:2016-04-01 00:00:00

  • The worse the better? Quantile treatment effects of a conditional cash transfer programme on mental health.

    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

    authors: Ohrnberger J,Fichera E,Sutton M,Anselmi L

    更新日期:2020-11-20 00:00:00

  • Review of quality assessment tools for family planning programmes in low- and middle-income countries.

    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

    authors: Sprockett A

    更新日期:2017-03-01 00:00:00

  • Expenditure tracking and review of reproductive maternal, newborn and child health policy in Pakistan.

    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

    authors: Malik MA,Nahyoun AS,Rizvi A,Bhatti ZA,Bhutta ZA

    更新日期:2017-07-01 00:00:00

  • Dropping out of Ethiopia's community-based health insurance scheme.

    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

    authors: Mebratie AD,Sparrow R,Yilma Z,Alemu G,Bedi AS

    更新日期:2015-12-01 00:00:00

  • Can innovative health financing policies increase access to MDG-related services? Evidence from Rwanda.

    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

    authors: Sekabaraga C,Diop F,Soucat A

    更新日期:2011-11-01 00:00:00

  • Health policy-making in central and eastern Europe: lessons from the inaction on injuries?

    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

    authors: McKee M,Zwi A,Koupilova I,Sethi D,Leon D

    更新日期:2000-09-01 00:00:00

  • From the field side of the binoculars: a different view on global public health surveillance.

    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

    authors: Calain P

    更新日期:2007-01-01 00:00:00

  • Reforming health service delivery at district level in Ghana: the perspective of a district medical officer.

    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

    authors: Agyepong IA

    更新日期:1999-03-01 00:00:00

  • Impact of integrated healthcare: Taiwan's Family Doctor Plan.

    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

    authors: Liang LL

    更新日期:2019-11-01 00:00:00

  • Transcalar networks for policy transfer and implementation: the case of global health policies for malaria and HIV/AIDS in Cameroon.

    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

    authors: Ngoasong MZ

    更新日期:2011-01-01 00:00:00

  • Safe motherhood voucher programme coverage of health facility deliveries among poor women in South-western Uganda.

    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

    authors: Kanya L,Obare F,Warren C,Abuya T,Askew I,Bellows B

    更新日期:2014-07-01 00:00:00

  • A stakeholder analysis.

    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

    authors: Varvasovszky Z,Brugha R

    更新日期:2000-09-01 00:00:00

  • Costs and cost-effectiveness of a mental health intervention for war-affected young persons: decision analysis based on a randomized controlled trial.

    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

    authors: McBain RK,Salhi C,Hann K,Salomon JA,Kim JJ,Betancourt TS

    更新日期:2016-05-01 00:00:00

  • Does an expansion in private sector contraceptive supply increase inequality in modern contraceptive use?

    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

    authors: Agha S,Do M

    更新日期:2008-11-01 00:00:00

  • A home visit-based early childhood stimulation programme in Brazil-a randomized controlled trial.

    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

    authors: Brentani A,Walker S,Chang-Lopez S,Grisi S,Powell C,Fink G

    更新日期:2021-01-26 00:00:00

  • From public to private and back again: sustaining a high service-delivery level during transition of management authority: a Cambodia case study.

    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

    authors: Jacobs B,Thomé JM,Overtoom R,Sam SO,Indermühle L,Price N

    更新日期:2010-05-01 00:00:00

  • Utilization of private and public health-care providers for tuberculosis symptoms in Ho Chi Minh City, Vietnam.

    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

    authors: Lönnroth K,Thuong LM,Linh PD,Diwan VK

    更新日期:2001-03-01 00:00:00

  • Self-undermining policy feedback and the creation of National Health Insurance in Ghana.

    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

    authors: Wireko I,Béland D,Kpessa-Whyte M

    更新日期:2020-11-20 00:00:00

  • Negotiating markets for health: an exploration of physicians' engagement in dual practice in three African capital cities.

    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

    authors: Russo G,McPake B,Fronteira I,Ferrinho P

    更新日期:2014-09-01 00:00:00

  • Dual practice of public hospital physicians in Vietnam.

    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

    authors: Do N,Do YK

    更新日期:2018-10-01 00:00:00

  • Counting indirect crisis-related deaths in the context of a low-resilience health system: the case of maternal and neonatal health during the Ebola epidemic in Sierra Leone.

    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

    authors: Sochas L,Channon AA,Nam S

    更新日期:2017-11-01 00:00:00

  • Determinants of patient choice of medical provider: a case study in rural China.

    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

    authors: Yip WC,Wang H,Liu Y

    更新日期:1998-09-01 00:00:00