Do the determinants of institutional delivery among childbearing women differ by health insurance enrolment? Findings from a population-based study in Nigeria.

Abstract

Studies in Nigeria have identified several individual and contextual determinants of institutional delivery among childbearing women. However, it is not clear in literature whether these determinants are peculiar to women who enrolled or do not enrolled in health insurance schemes. This study compares the determinants of institutional delivery among childbearing women who either enrolled or do not enrolled in health insurance schemes in Nigeria. The study was based on women's data from the 2018 Nigeria Demographic and Health Survey. A weighted sample size of 17,465 women was analysed. Stata 14 was used to perform data analysis. Three binary logistic regression models were estimated. Results show higher prevalence of institutional delivery among women who enrolled in health insurance (39.3% vs. 70.5%). Result further reveal differences in the determinants of institutional delivery among the women with sex of head of household (adjusted odds ratio [AOR]=1.340, p<0.05; 95% CI: 1.121-1.602), type of marriage (AOR=0.817, p<0.05; 95% CI: 0.727-0.918) and status of most recent delivery (AOR=0.703, p<0.001; 95% 95% CI: 0.631-0.781) showing significance among women not enrolled in health insurance but insignificant among women enrolled in health insurance. Differences in determinants of institutional delivery among the women may be attributed to differences in their socio-demographic condition.