Open Access Peer-reviewed Research Article

Main Article Content

Rolle Remi Ahuru corresponding author
Daniel Osaze
Akpojubaro Henry Efegbere


Purpose: Health insurance reduces the cost of using modern maternal and child cares and encourages women to use modern care services. This is because health insurance scheme spread the burden of maternal care usage across people and overtime. In Nigeria, there is a dearth of research evidence on the effect of health insurance enrolment on maternal and childcare use. This study examined the effect of health insurance coverage on maternal and childcare use in Nigeria, drawing upon data from the most recent National Demographic and Health Survey (2018). 
Methods: Three outcome indicators were used: a minimum of four antenatal care (ANC) visits, place of delivery, and complete child immunization. Descriptive and predictive analytical methods were utilized. A representative sample of 33,715 women who reported recent birth within the last five years preceding the Survey was used for the analyses. Analyses were undertaken using STATA version 13.0 for windows. 
Results: The results showed that 57% of the women made a minimum of four ANC visits, 41% delivered in health institutions, and 27% undertook complete child immunization. Enrolment in health insurance was low as only 2.3% of the women were under any form of health insurance coverage. However, enrolment in health insurance significantly improves the odds for a minimum of four ANC visits [aOR: 1.52, р = 0.00] and health facility delivery [aOR: 1.42, р = 0.00]. However, there is no significant difference in complete child immunization between women who were under health insurance and those who were not [aOR: 1.36, р = 0.28]. Also, residing in an urban area, Southern geopolitical zones, and being drawn from wealthy homes confer an advantage on women to use modern maternal and child healthcare. 
Conclusion: Pragmatic interventions should be initiated to encourage women’s enrolment in health insurance in Nigeria. Community-based health insurance scheme should be encouraged among rural women and those of them in the informal sector

influence, health insurance, maternal, childcare, Nigeria

Article Details

How to Cite
Ahuru, R., Osaze, D., & Efegbere, A. (2021). The influence of health insurance enrolment on maternal and childcare use in Nigeria. Social Work and Social Welfare, 2(1), 82-90.


  1. WHO, UNICEF, UNFPA, World Bank, and the United Nations Population Division (2017) Trends in maternal mortality: 2000- 2017 Geneva: World Health Organization.
  2. Yaya S, Da F, Wang R, et al. Maternal healthcare insurance ownership and service utilization in Ghana: Analysis of Ghana Demographic and Health Survey. PLoS ONE, 2019, 14(4): e0214841.
  3. Yaya S, Okonofua F, Ntoimo L, et al. Gender inequity as a barrier to women’s access to skilled pregnancy care in rural Nigeria: a qualitative study. International health, 2019, 11(6): 551-560.
  4. Rolle RA and Iseghohi OJ. Predictors of Antenatal Care Utilization in Primary Healthcare Centers in Eight Rural Communities in Delta State, Nigeria. African Journal of Health Economics, 2019, 8(1): 1-22.
  5. De Browere V. Strategies for reducing maternal mortality in developing countries: What can we learn from the history of industrialized west? Tropical Medicine and International Health, 1998, 3(10): 771- 782.
  6. WHO: World Health Report. WHO Geneva, 2000.
  7. Fagbamigbe AF and Idemudia ES. Barriers to antenatal care use in Nigeria: evidence from non-users and implications for maternal health programming. BMC Pregnancy Childbirth, 2015, 15: 95.
  8. Okonofua F, Ntoimo L, Ogungbangbe J, et al. Predictors of Women utilization of PHC for skilled pregnancy care in rural Nigeria. BMC pregnancy and child, 2018, 18: 106.
  9. Singh A. Supply-side barriers to maternal healthcare utilization at health sub Centre in India. Peer J, 2016, 4: e2675.
  10. Dahiru T and Oche OM. Determinants of antenatal care, institutional delivery and postnatal care services utilization in Nigeria. Pan African medical journal, 2015, 21: 321.
  11. Nketiah-Amponsah E and Arthur E. Choice of delivery facility among expectant mothers in Ghana: does access to health insurance matter? Journal of Health Management, 2013, 15(4): 509-524.
  12. Adinma ED and Adinma BDJ. Community-based healthcare financing: An untapped option to a more effective healthcare funding in Nigeria. Nigerian Medical Journal, 2010, 51(3): 95.
  13. National Population Commission N. Nigeria demographic and health survey 2018. Abuja: National Population Commission. 2018: 630.
  14. Ahuru RR. The influence of women empowerment on maternal and childcare use in Nigeria. International Journal of Healthcare Management. 2019, 12: 1-10.
  15. Nketiah-Amponsah E, Senadza B and Arthur E. Determinants of the utilization of antenatal care services in developing countries. African Journal of Economic and Management Studies. 2013, 4(1): 58-73.
  16. Mensah J, Oppong JR and Schmidt CM. Ghana’s National Health Insurance Scheme in the context of the health MDGs: an empirical evaluation using propensity score matching. Health Economics, 2010, 19(Supp 1):95-106.
  17. De Allegri M, Ridde V, Louis VR, et al. Determinants of the utilization of maternal care services after the reduction of user fees: a case study from rural Burkina Faso. Health policy, 2011, 99(3): 210-218.
  18. Kibusi SM, Sunguya BF, Kimunai E, et al. Health insurance is important in improving maternal health service utilization in Tanzania-analysis of the 2011/2012 Tanzania HIV/AIDS and malaria indicator Survey. Bmc Health Services Research, 2018, 18(1): 112.
  19. Wang W, Gheda T and Lindsay M. Health Insurance Coverage and Its Impact on Maternal Health Care Utilization in Low-and Middle-Income Countries. DHS Analytical Studies No. 45. Rockville, Maryland, USA: ICF International, 2014
  20. Rashad AS, Sharaf MF and Mansour EI. Does public health insurance increase maternal health care utilization in Egypt? Journal of International Development, 2019, 31(6): 516-520.
  21. Okigbo CC and Eke AC. Skilled birth attendance in Nigeria: a function of frequency and content of antenatal care. African journal of reproductive health, 2015, 19(1): 25-33.
  22. Fagbamigbe AF and Idemudia ES.Wealth and antenatal care utilization in Nigeria: policy implications. Health care for women international, 2017, 38(1): 17-37.
  23. Arthur E. Wealth and antenatal care use: implications for maternal health care utilization in Ghana. Health Economic Review, 2012, 2(14): 1-18.
  24. Ortiz AV. Determinants of demand for antenatal care in Columbia. Health Policy, 2007, 86(2-3): 363-372.
  25. Wilunda C, Quagho G, Putoto G, et al. Determinants of Utilization of antenatal care and skilled birth attendant in South West Shoa Zone, Ethiopia: a cross-sectional study. Reproductive Health, 2015, 12: 74.