The Factors Associated with Ownership of Health Insurance Among Women of Reproductive Health in Guyana
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Abstract
Women of reproductive age are one vulnerable group because of the phase of pregnancy, childbirth, and contraceptive use. Due to those reasons, they need to be covered by health insurance. However, the coverage of health insurance remains low, especially in developing countries including Guyana. This study aimed to examine the factors associated with ownership of health insurance among women of reproductive age. This study used the data from Multiple Indicators Cluster Survey Wave 6 (MICS6) Guyana in 2019-2020. Totally, 5,470 women met the criteria. The multivariate analysis was done by 2 models including the community characteristics. It was found some factors related to having or not having health insurance, including living in Damerara-Mahaica and Mahaica-Berbice regions, having Muslim, female, and from Amerindian, East Indian, and Mixed ethnic of household head, having a higher wealth index and education level, aged 30-34, and formerly marriage or never married. The health insurance scheme needs to be arranged especially at tat regional level to ensure women can access maternal services easily and effectively.
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How to Cite
Rusmitasari, H., Santoso, E., Supriatin, S., & Maretalinia, M. (2024). The Factors Associated with Ownership of Health Insurance Among Women of Reproductive Health in Guyana. Unnes Journal of Public Health, 13(1), 39-48. https://doi.org/10.15294/ujph.v13i1.70196
References
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Adepoju, O., Mask, A., & McLeod, A. (2019). Factors associated with health insurance literacy: proficiency in finding, selecting, and making appropriate decisions. Journal of Healthcare Management, 64(2), 79–89.
Astari, D. W., & Kismiantini. (2019). Analysis of Factors Affecting the Health Insurance Ownership with Binary Logistic Regression Model. Journal of Physics: Conference Series, 1320(1), 12011. https://doi.org/10.1088/1742-6596/1320/1/012011
Bailey, M. J., & Lindo, J. M. (2017). Access and Use of Contraception and Its Effects on Women’s Outcomes in the US. National Bureau of Economic Research.
Bayked, E. M., Kahissay, M. H., & Workneh, B. D. (2019). Factors affecting community based health insurance utilization in Ethiopia: a systematic review.
Buchmueller, T. C., Levinson, Z. M., Levy, H. G., & Wolfe, B. L. (2016). Effect of the Affordable Care Act on racial and ethnic disparities in health insurance coverage. American Journal of Public Health, 106(8), 1416–1421. https://doi.org/10.2105/AJPH.2016.303155
Cohen, R. A., Martinez, M. E., & Zammitti, E. P. (2016). Health insurance coverage: early release of estimates from the National Health Interview Survey, 2015.
Conn, C. P., & Walford, V. (1998). An introduction to health insurance for low income countries. London: Institute for Health Sector Development.
Das, J., & Do, Q.-T. (2023). The Prices in the Crises: What We Are Learning from Twenty Years of Health Insurance in Low-and Middle-Income Countries. National Bureau of Economic Research.
Dimbuene, Z. T., Nzuzi, R. M., & Kikhela, P.-D. N. (2022). Poverty, education and health insurance coverage among women of reproductive ages in the Democratic Republic of the Congo: a cross-sectional and multilevel analysis. BMJ Open, 12(12), e064834. https://doi.org/10.1136/bmjopen-2022-064834
Hosler, A. S., & Kammer, J. R. (2018). A comprehensive health profile of Guyanese immigrants aged 18–64 in Schenectady, New York. Journal of Immigrant and Minority Health, 20, 972–980.
Johnston, E. M., Strahan, A. E., Joski, P., Dunlop, A. L., & Adams, E. K. (2018). Impacts of the Affordable Care Act’s Medicaid expansion on women of reproductive age: differences by parental status and state policies. Women’s Health Issues, 28(2), 122–129.
Khalil, I., Collison, M., El Bcheraoui, C., Charara, R., Moradi-Lakeh, M., Afshin, A., Chew, A., Daoud, F., Krohn, K. J., Colombara, D., Ehrenkranz, R., Kutz, M., Wang, H., Abajobir, A. A., Abd-Allah, F., Abraha, H. N., Abu-Raddad, L. J., Ahmad Kiadaliri, A., Ahmadi, A., … Collaborators, G. B. D. 2015 E. M. R. M. M. (2018). Maternal mortality and morbidity burden in the Eastern Mediterranean Region: findings from the Global Burden of Disease 2015 study. International Journal of Public Health, 63(1), 47–61. https://doi.org/10.1007/s00038-017-1004-3
Klatman, E. L., Singh, K., & Ogle, G. D. (2017). The Road to Free Insulin. Guyana Case Study. www.haiweb.org
Likka, M. H., Handalo, D. M., Weldsilase, Y. A., & Sinkie, S. O. (2018). The effect of community-based health insurance schemes on utilization of healthcare services in low-and middle-income countries: a systematic review protocol of quantitative evidence. JBI Evidence Synthesis, 16(3), 653–661.
Mailhot Vega, R. B., Balogun, O. D., Ishaq, O. F., Bray, F., Ginsburg, O., & Formenti, S. C. (2019). Estimating child mortality associated with maternal mortality from breast and cervical cancer. Cancer, 125(1), 109–117.
Majeed, M. D. (2021). Continuity of care: the ongoing use of “bush medicine” as a transnational therapeutic health practice in Guyanese immigrant communities. Health & Place, 71, 102643. https://doi.org/10.1016/j.healthplace.2021.102643
Meng, Q., Fang, H., Liu, X., Yuan, B., & Xu, J. (2015). Consolidating the social health insurance schemes in China: towards an equitable and efficient health system. The Lancet, 386(10002), 1484–1492. https://doi.org/10.1016/S0140-6736(15)00342-6
Mills, A. (2014). Health Care Systems in Low- and Middle-Income Countries. New England Journal of Medicine, 370(6), 552–557. https://doi.org/10.1056/NEJMra1110897
Misir, P. (2015). Health care reform in Guyana. Social Medicine, 9(1), 36–47. https://doi.org/10.4103/1119-3077.154196
Molk, P. (2016). The ownership of health insurers. U. Ill. L. Rev., 873.
Oesman, H. (2017). The pattern of contraceptive use and utilization of BPJS-health card on family planning services in Indonesia. Jakarta: Pusat Penelitian Dan Pengembangan Keluarga Berencana Dan Keluarga Sejahtera, Badan Kependudukan Dan Keluarga Berencana. J Kesehat Reproduksi, 8(1), 2017.
Pisani, E., Olivier Kok, M., & Nugroho, K. (2017). Indonesia’s road to universal health coverage: a political journey. Health Policy and Planning, 32(2), 267–276. https://doi.org/10.1093/heapol/czw120
Prasetyo, R. A., & Haksama, S. (2022). Pengaruh Tingkat Pendidikan dan Pengetahuan terhadap Kepemilikan BPJS Ketenagakerjaan pada Relawan Penanggulangan Bencana Gunung Semeru Tahun 2021. Preventia: The Indonesian Journal of Public Health, 7(2), 61–66. https://doi.org/10.17977/um044v7i22022p61-66
Román, N. I. S., & Bochnakova, T. (2017). Radiology abroad: a global health initiative in Guyana. Academic Radiology, 24(6), 753–754.
Sari, A. N., Susanti, A. I., Indraswari, N., Ekawati, R., & Suhenda, D. (2021). An Analysis of Sociodemography, Knowledge, Source of Information, and Health Insurance Ownership on the Behaviour of Women of Childbearing Age in Contraception Use in West Java. Malaysian Journal of Public Health Medicine, 21(3), 183–191. https://doi.org/10.37268/mjphm/vol.21/no.3/art.964
Shao, L., Wang, Y., Wang, X., Ji, L., & Huang, R. (2022). Factors associated with health insurance ownership among women of reproductive age: a multicountry study in sub-Saharan Africa. Plos One, 17(4), e0264377.
Tan, C., Wyatt, L. C., Kranick, J. A., Kwon, S. C., & Oyebode, O. (2018). Factors associated with health insurance status in an Asian American population in New York City: analysis of a community-based survey. Journal of Racial and Ethnic Health Disparities, 5, 1354–1364.
Tlou, B., Sartorius, B., & Tanser, F. (2017). Space-time patterns in maternal and mother mortality in a rural South African population with high HIV prevalence (2000–2014): results from a population-based cohort. BMC Public Health, 17(1), 543. https://doi.org/10.1186/s12889-017-4463-9
USAID. (2011). Guyana Health System Assessment 2010. https://www.hfgproject.org/wp-content/uploads/2015/02/Guyana-Health-System-Assessment-2010.pdf
Uzochukwu, B. S. C., Ughasoro, M. D., Etiaba, E., Okwuosa, C., Envuladu, E., & Onwujekwe, O. E. (2015). Health care financing in Nigeria: Implications for achieving universal health coverage. Nigerian Journal of Clinical Practice, 18(4), 437–444.
Wang, W., Temsah, G., & Mallick, L. (2016). The impact of health insurance on maternal health care utilization: Evidence from Ghana. In Health Policy Plan (Vol. 32, pp. 366–375). Indonesia and Rwanda. https://doi.org/10.1093/heapol/czw135.
Wang, Y., Wang, X., Ji, L., & Huang, R. (2021). Sociodemographic inequalities in health insurance ownership among women in selected francophone countries in Sub-Saharan Africa. BioMed Research International, 2021.
World Health Organization. (2003). Community based health insurance schemes in developing countries: facts, problems and perspectives. World Health Organization.
World Health Organization. (2018). WHO country cooperation strategy at a glance: Guyana. World Health Organization.
Adepoju, O., Mask, A., & McLeod, A. (2019). Factors associated with health insurance literacy: proficiency in finding, selecting, and making appropriate decisions. Journal of Healthcare Management, 64(2), 79–89.
Astari, D. W., & Kismiantini. (2019). Analysis of Factors Affecting the Health Insurance Ownership with Binary Logistic Regression Model. Journal of Physics: Conference Series, 1320(1), 12011. https://doi.org/10.1088/1742-6596/1320/1/012011
Bailey, M. J., & Lindo, J. M. (2017). Access and Use of Contraception and Its Effects on Women’s Outcomes in the US. National Bureau of Economic Research.
Bayked, E. M., Kahissay, M. H., & Workneh, B. D. (2019). Factors affecting community based health insurance utilization in Ethiopia: a systematic review.
Buchmueller, T. C., Levinson, Z. M., Levy, H. G., & Wolfe, B. L. (2016). Effect of the Affordable Care Act on racial and ethnic disparities in health insurance coverage. American Journal of Public Health, 106(8), 1416–1421. https://doi.org/10.2105/AJPH.2016.303155
Cohen, R. A., Martinez, M. E., & Zammitti, E. P. (2016). Health insurance coverage: early release of estimates from the National Health Interview Survey, 2015.
Conn, C. P., & Walford, V. (1998). An introduction to health insurance for low income countries. London: Institute for Health Sector Development.
Das, J., & Do, Q.-T. (2023). The Prices in the Crises: What We Are Learning from Twenty Years of Health Insurance in Low-and Middle-Income Countries. National Bureau of Economic Research.
Dimbuene, Z. T., Nzuzi, R. M., & Kikhela, P.-D. N. (2022). Poverty, education and health insurance coverage among women of reproductive ages in the Democratic Republic of the Congo: a cross-sectional and multilevel analysis. BMJ Open, 12(12), e064834. https://doi.org/10.1136/bmjopen-2022-064834
Hosler, A. S., & Kammer, J. R. (2018). A comprehensive health profile of Guyanese immigrants aged 18–64 in Schenectady, New York. Journal of Immigrant and Minority Health, 20, 972–980.
Johnston, E. M., Strahan, A. E., Joski, P., Dunlop, A. L., & Adams, E. K. (2018). Impacts of the Affordable Care Act’s Medicaid expansion on women of reproductive age: differences by parental status and state policies. Women’s Health Issues, 28(2), 122–129.
Khalil, I., Collison, M., El Bcheraoui, C., Charara, R., Moradi-Lakeh, M., Afshin, A., Chew, A., Daoud, F., Krohn, K. J., Colombara, D., Ehrenkranz, R., Kutz, M., Wang, H., Abajobir, A. A., Abd-Allah, F., Abraha, H. N., Abu-Raddad, L. J., Ahmad Kiadaliri, A., Ahmadi, A., … Collaborators, G. B. D. 2015 E. M. R. M. M. (2018). Maternal mortality and morbidity burden in the Eastern Mediterranean Region: findings from the Global Burden of Disease 2015 study. International Journal of Public Health, 63(1), 47–61. https://doi.org/10.1007/s00038-017-1004-3
Klatman, E. L., Singh, K., & Ogle, G. D. (2017). The Road to Free Insulin. Guyana Case Study. www.haiweb.org
Likka, M. H., Handalo, D. M., Weldsilase, Y. A., & Sinkie, S. O. (2018). The effect of community-based health insurance schemes on utilization of healthcare services in low-and middle-income countries: a systematic review protocol of quantitative evidence. JBI Evidence Synthesis, 16(3), 653–661.
Mailhot Vega, R. B., Balogun, O. D., Ishaq, O. F., Bray, F., Ginsburg, O., & Formenti, S. C. (2019). Estimating child mortality associated with maternal mortality from breast and cervical cancer. Cancer, 125(1), 109–117.
Majeed, M. D. (2021). Continuity of care: the ongoing use of “bush medicine” as a transnational therapeutic health practice in Guyanese immigrant communities. Health & Place, 71, 102643. https://doi.org/10.1016/j.healthplace.2021.102643
Meng, Q., Fang, H., Liu, X., Yuan, B., & Xu, J. (2015). Consolidating the social health insurance schemes in China: towards an equitable and efficient health system. The Lancet, 386(10002), 1484–1492. https://doi.org/10.1016/S0140-6736(15)00342-6
Mills, A. (2014). Health Care Systems in Low- and Middle-Income Countries. New England Journal of Medicine, 370(6), 552–557. https://doi.org/10.1056/NEJMra1110897
Misir, P. (2015). Health care reform in Guyana. Social Medicine, 9(1), 36–47. https://doi.org/10.4103/1119-3077.154196
Molk, P. (2016). The ownership of health insurers. U. Ill. L. Rev., 873.
Oesman, H. (2017). The pattern of contraceptive use and utilization of BPJS-health card on family planning services in Indonesia. Jakarta: Pusat Penelitian Dan Pengembangan Keluarga Berencana Dan Keluarga Sejahtera, Badan Kependudukan Dan Keluarga Berencana. J Kesehat Reproduksi, 8(1), 2017.
Pisani, E., Olivier Kok, M., & Nugroho, K. (2017). Indonesia’s road to universal health coverage: a political journey. Health Policy and Planning, 32(2), 267–276. https://doi.org/10.1093/heapol/czw120
Prasetyo, R. A., & Haksama, S. (2022). Pengaruh Tingkat Pendidikan dan Pengetahuan terhadap Kepemilikan BPJS Ketenagakerjaan pada Relawan Penanggulangan Bencana Gunung Semeru Tahun 2021. Preventia: The Indonesian Journal of Public Health, 7(2), 61–66. https://doi.org/10.17977/um044v7i22022p61-66
Román, N. I. S., & Bochnakova, T. (2017). Radiology abroad: a global health initiative in Guyana. Academic Radiology, 24(6), 753–754.
Sari, A. N., Susanti, A. I., Indraswari, N., Ekawati, R., & Suhenda, D. (2021). An Analysis of Sociodemography, Knowledge, Source of Information, and Health Insurance Ownership on the Behaviour of Women of Childbearing Age in Contraception Use in West Java. Malaysian Journal of Public Health Medicine, 21(3), 183–191. https://doi.org/10.37268/mjphm/vol.21/no.3/art.964
Shao, L., Wang, Y., Wang, X., Ji, L., & Huang, R. (2022). Factors associated with health insurance ownership among women of reproductive age: a multicountry study in sub-Saharan Africa. Plos One, 17(4), e0264377.
Tan, C., Wyatt, L. C., Kranick, J. A., Kwon, S. C., & Oyebode, O. (2018). Factors associated with health insurance status in an Asian American population in New York City: analysis of a community-based survey. Journal of Racial and Ethnic Health Disparities, 5, 1354–1364.
Tlou, B., Sartorius, B., & Tanser, F. (2017). Space-time patterns in maternal and mother mortality in a rural South African population with high HIV prevalence (2000–2014): results from a population-based cohort. BMC Public Health, 17(1), 543. https://doi.org/10.1186/s12889-017-4463-9
USAID. (2011). Guyana Health System Assessment 2010. https://www.hfgproject.org/wp-content/uploads/2015/02/Guyana-Health-System-Assessment-2010.pdf
Uzochukwu, B. S. C., Ughasoro, M. D., Etiaba, E., Okwuosa, C., Envuladu, E., & Onwujekwe, O. E. (2015). Health care financing in Nigeria: Implications for achieving universal health coverage. Nigerian Journal of Clinical Practice, 18(4), 437–444.
Wang, W., Temsah, G., & Mallick, L. (2016). The impact of health insurance on maternal health care utilization: Evidence from Ghana. In Health Policy Plan (Vol. 32, pp. 366–375). Indonesia and Rwanda. https://doi.org/10.1093/heapol/czw135.
Wang, Y., Wang, X., Ji, L., & Huang, R. (2021). Sociodemographic inequalities in health insurance ownership among women in selected francophone countries in Sub-Saharan Africa. BioMed Research International, 2021.
World Health Organization. (2003). Community based health insurance schemes in developing countries: facts, problems and perspectives. World Health Organization.
World Health Organization. (2018). WHO country cooperation strategy at a glance: Guyana. World Health Organization.