A Description of Maternal and Child Health in Rural Kenya, Nigeria and Tanzania & The Potential for a Health Insurance Program to Improve Maternal and Child Health
The purpose of this study is to describe maternal and child health in Kenya, Nigeria and Tanzania before implementation of the HIF program. In addition, valuable knowledge on the potential for the HIF program is provided in order to improve maternal and child health in the intervention areas in these three countries. This has been done by specifically focusing on the following health indices: reproductive health, family planning, measured health, utilization of antenatal care, choice for hospital delivery, complications during delivery, vaccinations and early nutrition.
This study draws on four rich data sets gathered as part of a multi‒year operational research program on the HIF interventions led by the Amsterdam Institute for International Development (AIID) and the Amsterdam Institute for Global Health and Development (AIGHD). In order to carry out an evaluation of the impact of the health insurance programs, the HIF funded the implementation of extensive household surveys in Kenya, Nigeria and Tanzania. It simultaneously funded an in‒depth evaluation of the HIF program on maternal and child health (MACHS) in Nigeria.
Establishing the potential benefits of integrated interventions is of particular interest from a policy perspective. Recently, a report on the short term impact of the HIF program in Central Kwara State, Nigeria was published. The focus of this evaluation was the impact of health insurance on healthcare utilization and out−of−pocket expenditures on healthcare. The results show that healthcare utilization in the program area almost doubled, whilst rates remained stable in the control area (where health insurance was not made available). Furthermore, in the intervention area out−of−pocket expenditures were cut by 50%. It was particularly noticeable that the results were strongest for the poorer half of the population and for those below the age of 18 (AIID, 2013). Evidently, making health insurance available while simultaneously upgrading the quality of the participating health facilities has the desired effect of increasing access to affordable healthcare in this population. This study portrays the lack of access to healthcare and the poor quality of already available healthcare, which is one of the underlying causes of high maternal and child mortality in Kenya, Nigeria and Tanzania. If there is a potential for health insurance to improve maternal and child health, then this finding can serve as an important tool to inform the policy dialogue.
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