Health insurance and child mortality in rural Burkina Faso
Background: Micro health insurance schemes have been implemented across developing countries as a means of facilitating access to modern medical care, with the ultimate aim of improving health. This effect, however, has not been explored sufficiently. Objective: We investigated the effect of enrolme...
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doaj-ae5378f447994bc4b5bebf4220e60ea72020-11-24T22:25:26ZengTaylor & Francis GroupGlobal Health Action1654-98802015-04-01801810.3402/gha.v8.2732727327Health insurance and child mortality in rural Burkina FasoAnja Schoeps0Henrike Lietz1Ali Sié2Germain Savadogo3Manuela De Allegri4Olaf Müller5Rainer Sauerborn6Heiko Becher7Aurélia Souares8 Institute of Public Health, University of Heidelberg, Heidelberg, Germany Institute of Public Health, University of Heidelberg, Heidelberg, Germany Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso Institute of Public Health, University of Heidelberg, Heidelberg, Germany Institute of Public Health, University of Heidelberg, Heidelberg, Germany Institute of Public Health, University of Heidelberg, Heidelberg, Germany Institute of Public Health, University of Heidelberg, Heidelberg, Germany Institute of Public Health, University of Heidelberg, Heidelberg, GermanyBackground: Micro health insurance schemes have been implemented across developing countries as a means of facilitating access to modern medical care, with the ultimate aim of improving health. This effect, however, has not been explored sufficiently. Objective: We investigated the effect of enrolment into community-based health insurance on mortality in children under 5 years of age in a health and demographic surveillance system in Nouna, Burkina Faso. Design: We analysed the effect of health insurance enrolment on child mortality with a Cox regression model. We adjusted for variables that we found to be related to the enrolment in health insurance in a preceding analysis. Results: Based on the analysis of 33,500 children, the risk of mortality was 46% lower in children enrolled in health insurance as compared to the non-enrolled children (HR=0.54, 95% CI 0.43–0.68) after adjustment for possible confounders. We identified socioeconomic status, father's education, distance to the health facility, year of birth, and insurance status of the mother at time of birth as the major determinants of health insurance enrolment. Conclusions: The strong effect of health insurance enrolment on child mortality may be explained by increased utilisation of health services by enrolled children; however, other non-observed factors cannot be excluded. Because malaria is a main cause of death in the study area, early consultation of health services in case of infection could prevent many deaths. Concerning the magnitude of the effect, implementation of health insurance could be a major driving factor of reduction in child mortality in the developing world.http://www.globalhealthaction.net/index.php/gha/article/view/27327/pdf_37health insuranceAfrica South of the Saharachild mortalitypopulation surveillanceBurkina Fasohealth services accessibilitysurvival analysis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Anja Schoeps Henrike Lietz Ali Sié Germain Savadogo Manuela De Allegri Olaf Müller Rainer Sauerborn Heiko Becher Aurélia Souares |
spellingShingle |
Anja Schoeps Henrike Lietz Ali Sié Germain Savadogo Manuela De Allegri Olaf Müller Rainer Sauerborn Heiko Becher Aurélia Souares Health insurance and child mortality in rural Burkina Faso Global Health Action health insurance Africa South of the Sahara child mortality population surveillance Burkina Faso health services accessibility survival analysis |
author_facet |
Anja Schoeps Henrike Lietz Ali Sié Germain Savadogo Manuela De Allegri Olaf Müller Rainer Sauerborn Heiko Becher Aurélia Souares |
author_sort |
Anja Schoeps |
title |
Health insurance and child mortality in rural Burkina Faso |
title_short |
Health insurance and child mortality in rural Burkina Faso |
title_full |
Health insurance and child mortality in rural Burkina Faso |
title_fullStr |
Health insurance and child mortality in rural Burkina Faso |
title_full_unstemmed |
Health insurance and child mortality in rural Burkina Faso |
title_sort |
health insurance and child mortality in rural burkina faso |
publisher |
Taylor & Francis Group |
series |
Global Health Action |
issn |
1654-9880 |
publishDate |
2015-04-01 |
description |
Background: Micro health insurance schemes have been implemented across developing countries as a means of facilitating access to modern medical care, with the ultimate aim of improving health. This effect, however, has not been explored sufficiently. Objective: We investigated the effect of enrolment into community-based health insurance on mortality in children under 5 years of age in a health and demographic surveillance system in Nouna, Burkina Faso. Design: We analysed the effect of health insurance enrolment on child mortality with a Cox regression model. We adjusted for variables that we found to be related to the enrolment in health insurance in a preceding analysis. Results: Based on the analysis of 33,500 children, the risk of mortality was 46% lower in children enrolled in health insurance as compared to the non-enrolled children (HR=0.54, 95% CI 0.43–0.68) after adjustment for possible confounders. We identified socioeconomic status, father's education, distance to the health facility, year of birth, and insurance status of the mother at time of birth as the major determinants of health insurance enrolment. Conclusions: The strong effect of health insurance enrolment on child mortality may be explained by increased utilisation of health services by enrolled children; however, other non-observed factors cannot be excluded. Because malaria is a main cause of death in the study area, early consultation of health services in case of infection could prevent many deaths. Concerning the magnitude of the effect, implementation of health insurance could be a major driving factor of reduction in child mortality in the developing world. |
topic |
health insurance Africa South of the Sahara child mortality population surveillance Burkina Faso health services accessibility survival analysis |
url |
http://www.globalhealthaction.net/index.php/gha/article/view/27327/pdf_37 |
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