title: Obstetric benefits of health insurance: A comparative analysis of obstetric indices and outcome of enrollees and non-enrollees in southeast Nigeria.
abstract: This study determined the obstetric benefits and compared the obstetric indices and pregnancy outcome of enrollees and non-enrollees of the national health insurance scheme (NHIS). A prospective cohort study of enrollees and non-enrollees of NHIS was conducted over 2 years. Data was analysed with Epi-info statistical software. Malaria (25.3% versus 8.0%, p value ≤0.001), anaemia (11.3% versus 3.3%, p value ≤0.0001), preterm delivery (8.0% versus 2.7% p value = 0.00001), antenatal default rate (22.7% versus 6.7%, p value = 0.0001) and maternal death (2.7% versus 0.7%, p value = 0.00001) were higher in the non-insured. Singleton low birth weight (9.3% versus 2.7%, p value = 0.00001) and new born admission (10.7% versus 4.7%, p value = 0.00001) were also more in non-enrollee, with higher perinatal deaths (6.7% versus 2.0%, p value = 0.00001). Women managed under the Nigerian NHIS scheme had better maternal and perinatal indices, therefore, effort should be scaled up to ensure universal health insurance coverage for all parturient and their newborn.
authors.affiliation: a Department of Obstetrics & Gynaecology , Federal Teaching Hospital Abakaliki , Abakaliki , Ebonyi State , Nigeria.
authors.forename: Lucky Osaheni
authors.initials: LO
authors.lastname: Lawani
authors.affiliation: b Department of Obstetrics & Gynaecology , University of Nigeria Teaching Hospital , Enugu , Enugu State , Nigeria.
authors.forename: Chukwuemeka Anthony
authors.initials: CA
authors.lastname: Iyoke
authors.affiliation: a Department of Obstetrics & Gynaecology , Federal Teaching Hospital Abakaliki , Abakaliki , Ebonyi State , Nigeria.
authors.forename: Robinson Chukwudi
authors.initials: RC
authors.lastname: Onoh
authors.affiliation: b Department of Obstetrics & Gynaecology , University of Nigeria Teaching Hospital , Enugu , Enugu State , Nigeria.
authors.forename: Peter Onubiwe
authors.initials: PO
authors.lastname: Nkwo
authors.affiliation: c Department of Obstetrics & Gynaecology , Niger Delta University , Amassoma , Bayelsa State , Nigeria.
authors.forename: Isa Ayuba
authors.initials: IA
authors.lastname: Ibrahim
authors.affiliation: d Department of Obstetrics & Gynaecology , National Obstetric Fistula Center Abakaliki , Ebonyi State , Nigeria.
authors.forename: Kenneth Chinedu
authors.initials: KC
authors.lastname: Ekwedigwe
authors.affiliation: c Department of Obstetrics & Gynaecology , Niger Delta University , Amassoma , Bayelsa State , Nigeria.
authors.forename: Atombosoba Adokiye
authors.initials: AA
authors.lastname: Ekine
mesh_terms: D000328:Adult; D015331:Cohort Studies; D036861:Delivery, Obstetric / Q000191:economics / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007342:Insurance Benefits / Q000706:statistics & numerical data*; D008428:Maternal Mortality; D017057:Medically Uninsured / Q000706:statistics & numerical data; D009313:National Health Programs / Q000706:statistics & numerical data*; D009549:Nigeria / Q000453:epidemiology; D018743:Perinatal Care / Q000191:economics / Q000706:statistics & numerical data; D054238:Perinatal Mortality; D011247:Pregnancy; D011248:Pregnancy Complications / Q000191:economics / Q000453:epidemiology; D011256:Pregnancy Outcome / Q000191:economics / Q000453:epidemiology; D047928:Premature Birth / Q000191:economics / Q000453:epidemiology; D011446:Prospective Studies
keywords: Health insurance; enrollee; health financing; non-enrollee; obstetric indices; pregnancy outcome