Determinants of health insurance ownership among South African women.
BACKGROUND
Studies conducted in developed countries using economic models show that individual- and household- level variables are important determinants of health insurance ownership. There is however a dearth of such studies in sub-Saharan Africa. The objective of this study was to examine the relationship between health insurance ownership and the demographic, economic and educational characteristics of South African women.


METHODS
The analysis was based on data from a cross-sectional national household sample derived from the South African Health Inequalities Survey (SANHIS). The study subjects consisted of 3,489 women, aged between 16 and 64 years. It was a non-interventional, qualitative response econometric study. The outcome measure was the probability of a respondent's ownership of a health insurance policy.


RESULTS
The chi2 test for goodness of fit indicated satisfactory prediction of the estimated logit model. The coefficients of the covariates for area of residence, income, education, environment rating, age, smoking and marital status were positive, and all statistically significant at p < or = 0.05. Women who had standard 10 education and above (secondary), high incomes and lived in affluent provinces and permanent accommodations, had a higher likelihood of being insured.


CONCLUSIONS
Poverty reduction programmes aimed at increasing women's incomes in poor provinces; improving living environment (e.g. potable water supplies, sanitation, electricity and housing) for women in urban informal settlements; enhancing women's access to education; reducing unemployment among women; and increasing effective coverage of family planning services, will empower South African women to reach a higher standard of living and in doing so increase their economic access to health insurance policies and the associated health services.
Kirigia
Joses M
JM
World Health Organization, Regional Office for Africa, Brazzaville, Congo. kirigiaj@afro.who.int
Sambo
Luis G
LG
Nganda
Benjamin
B
Mwabu
Germano M
GM
Chatora
Rufaro
R
Mwase
Takondwa
T
D000293:Adolescent; D000328:Adult; D001294:Attitude to Health / Q000208:ethnology; D002755:Choice Behavior; D003430:Cross-Sectional Studies; D004651:Employment / Q000191:economics; D005191:Family Characteristics; D005260:Female; D006297:Health Services Accessibility / Q000191:economics; D006302:Health Services Research; D006801:Humans; D015273:Insurance Selection Bias; D007348:Insurance, Health / Q000706:statistics & numerical data*; D008875:Middle Aged; D017059:Models, Econometric; D010067:Ownership / Q000706:statistics & numerical data; D011203:Poverty; D011336:Probability; D012959:Socioeconomic Factors; D013019:South Africa; D014930:Women / Q000193:education* / Q000523:psychology
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