Women empowerment and health insurance utilisation in Rwanda: a nationwide cross-sectional survey
Abstract Background Health insurance coverage is one of the several measures being implemented to reduce the inequity in access to quality health services among vulnerable groups. Although women’s empowerment has been viewed as a cost-effective strategy for the reduction of maternal and child morbid...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-09-01
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| Series: | BMC Women's Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12905-022-01976-8 |
| _version_ | 1828377412184834048 |
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| author | Joseph Kawuki Ghislaine Gatasi Quraish Sserwanja |
| author_facet | Joseph Kawuki Ghislaine Gatasi Quraish Sserwanja |
| author_sort | Joseph Kawuki |
| collection | DOAJ |
| description | Abstract Background Health insurance coverage is one of the several measures being implemented to reduce the inequity in access to quality health services among vulnerable groups. Although women’s empowerment has been viewed as a cost-effective strategy for the reduction of maternal and child morbidity and mortality, as it enables women to tackle the barriers to accessing healthcare, its association with health insurance usage has been barely investigated. Our study aims at examining the prevalence of health insurance utilisation and its association with women empowerment as well as other socio-demographic factors among Rwandan women. Methods We used Rwanda Demographic and Health Survey (RDHS) 2020 data of 14,634 women aged 15–49 years, who were selected using multistage sampling. Health insurance utilisation, the outcome variable was a binary response (yes/no), while women empowerment was assessed by four composite indicators; exposure to mass media, decision making, economic and sexual empowerment. We conducted multivariable logistic regression to explore its association with socio-demographic factors, using SPSS (version 25). Results Out of the 14,634 women, 12,095 (82.6%) (95% CI 82.0–83.2) had health insurance, and the majority (77.2%) were covered by mutual/community organization insurance. Women empowerment indicators had a negative association with health insurance utilisation; low (AOR = 0.85, 95% CI 0.73–0.98) and high (AOR = 0.66, 95% CI 0.52–0.85) exposure to mass media, high decision making (AOR = 0.78, 95% CI 0.68–0.91) and high economic empowerment (AOR = 0.63, 95% CI 0.51–0.78). Other socio-demographic factors found significant include; educational level, wealth index, and household size which had a negative association, but residence and region with a positive association. Conclusions A high proportion of Rwandan women had health insurance, but it was negatively associated with women’s empowerment. Therefore, tailoring mass-media material considering the specific knowledge gaps to addressing misinformation, as well as addressing regional imbalance by improving women’s access to health facilities/services are key in increasing coverage of health insurance among women in Rwanda. |
| first_indexed | 2024-04-14T08:12:14Z |
| format | Article |
| id | doaj.art-d3581228e86546948b451bd918cbb733 |
| institution | Directory Open Access Journal |
| issn | 1472-6874 |
| language | English |
| last_indexed | 2024-04-14T08:12:14Z |
| publishDate | 2022-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Women's Health |
| spelling | doaj.art-d3581228e86546948b451bd918cbb7332022-12-22T02:04:31ZengBMCBMC Women's Health1472-68742022-09-0122111210.1186/s12905-022-01976-8Women empowerment and health insurance utilisation in Rwanda: a nationwide cross-sectional surveyJoseph Kawuki0Ghislaine Gatasi1Quraish Sserwanja2Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong KongKey Laboratory of Environmental Medicine Engineering, School of Public Health, Southeast UniversityProgrammes Department, GOALAbstract Background Health insurance coverage is one of the several measures being implemented to reduce the inequity in access to quality health services among vulnerable groups. Although women’s empowerment has been viewed as a cost-effective strategy for the reduction of maternal and child morbidity and mortality, as it enables women to tackle the barriers to accessing healthcare, its association with health insurance usage has been barely investigated. Our study aims at examining the prevalence of health insurance utilisation and its association with women empowerment as well as other socio-demographic factors among Rwandan women. Methods We used Rwanda Demographic and Health Survey (RDHS) 2020 data of 14,634 women aged 15–49 years, who were selected using multistage sampling. Health insurance utilisation, the outcome variable was a binary response (yes/no), while women empowerment was assessed by four composite indicators; exposure to mass media, decision making, economic and sexual empowerment. We conducted multivariable logistic regression to explore its association with socio-demographic factors, using SPSS (version 25). Results Out of the 14,634 women, 12,095 (82.6%) (95% CI 82.0–83.2) had health insurance, and the majority (77.2%) were covered by mutual/community organization insurance. Women empowerment indicators had a negative association with health insurance utilisation; low (AOR = 0.85, 95% CI 0.73–0.98) and high (AOR = 0.66, 95% CI 0.52–0.85) exposure to mass media, high decision making (AOR = 0.78, 95% CI 0.68–0.91) and high economic empowerment (AOR = 0.63, 95% CI 0.51–0.78). Other socio-demographic factors found significant include; educational level, wealth index, and household size which had a negative association, but residence and region with a positive association. Conclusions A high proportion of Rwandan women had health insurance, but it was negatively associated with women’s empowerment. Therefore, tailoring mass-media material considering the specific knowledge gaps to addressing misinformation, as well as addressing regional imbalance by improving women’s access to health facilities/services are key in increasing coverage of health insurance among women in Rwanda.https://doi.org/10.1186/s12905-022-01976-8Health insuranceUtilisationCoverageWomen empowermentRwanda |
| spellingShingle | Joseph Kawuki Ghislaine Gatasi Quraish Sserwanja Women empowerment and health insurance utilisation in Rwanda: a nationwide cross-sectional survey BMC Women's Health Health insurance Utilisation Coverage Women empowerment Rwanda |
| title | Women empowerment and health insurance utilisation in Rwanda: a nationwide cross-sectional survey |
| title_full | Women empowerment and health insurance utilisation in Rwanda: a nationwide cross-sectional survey |
| title_fullStr | Women empowerment and health insurance utilisation in Rwanda: a nationwide cross-sectional survey |
| title_full_unstemmed | Women empowerment and health insurance utilisation in Rwanda: a nationwide cross-sectional survey |
| title_short | Women empowerment and health insurance utilisation in Rwanda: a nationwide cross-sectional survey |
| title_sort | women empowerment and health insurance utilisation in rwanda a nationwide cross sectional survey |
| topic | Health insurance Utilisation Coverage Women empowerment Rwanda |
| url | https://doi.org/10.1186/s12905-022-01976-8 |
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