Poverty, education and Health insurance coverage among women of reproductive ages in the Democratic Republic of the Congo :a cross-sectional and multilevel analysis
Auteur(s): Tsala Dimbuene Zacharie, Muanza Nzuzi Raphaël, Nzita Kikhela Paul-DenisNom de la revue/Journal: BMJ Open
Mois: novembre
Volume: 12
Numéro: 064834
Année: 2022
pages: 11
Résumé
<p style="margin-left:auto;"><strong>Objective</strong> To investigate inequalities of health insurance coverage (outcome) at subnational level, and the effects of education and poverty on the outcome.</p><p style="margin-left:auto;"><strong>Design</strong> Secondary analysis of Demographic and Health Surveys. The outcome variable was health insurance ownership.</p><p style="margin-left:auto;"><strong>Setting</strong> The Democratic Republic of the Congo.</p><p style="margin-left:auto;"><strong>Subjects</strong> Women aged 15–49 years (n=18 827).</p><p style="margin-left:auto;"><strong>Results</strong> Findings indicated significant spatial variations of the health insurance ownership which ranged from 1.2% in Bandundu and Kasaï Oriental to 15.5% in Kinshasa the Capital City. Furthermore, findings showed that an additional year of women education increased by 10% the chance of health insurance ownership (adjusted OR, AOR 1.098; 95% CI 1.065 to 1.132). Finally, living in better-off households increased by 150% the chance of owing a health insurance (AOR 2.501; 95% CI 1.620 to 3.860) compared with women living in poor households.</p><p style="margin-left:auto;"><strong>Conclusions</strong> Given the low levels of health insurance coverage, the Democratic Republic of the Congo will not reach the Sustainable Development Goal 3, aimed at improving maternal and child health unless a serious programmatic health shift is undertaken in the country to tackle inequalities among poor and uneducated women via universal health coverage.</p>