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Equity of national publicly funded health insurance schemes under the universal health coverage agenda : a systematic review of studies conducted in Africa
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Anjorin, Seun S., Ayorinde, Abimbola, Abba, Mustapha, Mensah, Daniel, Okolie, Elvis A., Uthman, Olalekan A. and Oyebode, Oyinlola (2021) Equity of national publicly funded health insurance schemes under the universal health coverage agenda : a systematic review of studies conducted in Africa. Journal of Public Health . doi:10.1093/pubmed/fdab316 ISSN 1741-3842.
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Official URL: https://doi.org/10.1093/pubmed/fdab316
Abstract
Background
The implementation of publicly funded health insurance schemes (PFHIS) is the major strategy to drive progress and achievement of universal health coverage (UHC) by 2030. We appraised evidence on the equity of insurance schemes across Africa.
Methods
We conducted a systematic review of published studies that assessed equity in health insurance schemes implemented under the UHC agenda in Africa. Seven databases, Web of Science, Medline, CINAHL, Scopus, Cochrane Library, EMBASE and World Bank eLibrary, were searched; we operationalized the PROGRESS-Plus (place of residence; race/ethnicity/culture/language; occupation; gender/sex religion; education; socioeconomic status; social capital) equity framework to assess equity areas.
Results
Forty-five studies met the inclusion criteria and were included in the study, in which 90% assessed equity by socioeconomic status. Evidence showed that rural residents, those self-employed or working in the informal sector, men, those with lower educational attainment, and the poor were less likely to be covered by health insurance schemes. Broadly, the insurance schemes, especially, community-based health insurance (CBI) schemes improved utilization by disadvantaged groups, however, the same groups were less likely to benefit from health services.
Conclusions
Evidence on equity of PFHIS is mixed, however, CBI schemes seem to offer more equitable coverage and utilization of essential health services in Africa.
| Item Type: | Journal Article | |||||||||
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| Subjects: | H Social Sciences > HG Finance K Law [Moys] > KR Africa R Medicine > RA Public aspects of medicine |
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| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School | |||||||||
| SWORD Depositor: | Library Publications Router | |||||||||
| Library of Congress Subject Headings (LCSH): | Equity -- Africa, Health insurance policies -- Africa, Health insurance -- Africa, Health services accessibility -- Africa, Medical care -- Africa | |||||||||
| Journal or Publication Title: | Journal of Public Health | |||||||||
| Publisher: | Oxford University Press | |||||||||
| ISSN: | 1741-3842 | |||||||||
| Official Date: | 14 August 2021 | |||||||||
| Dates: |
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| DOI: | 10.1093/pubmed/fdab316 | |||||||||
| Status: | Peer Reviewed | |||||||||
| Publication Status: | Published | |||||||||
| Reuse Statement (publisher, data, author rights): | This is a pre-copyedited, author-produced version of an article accepted for publication in Journal of Public Health following peer review. The version of record Seun S Anjorin, Abimbola A Ayorinde, Mustapha S Abba, Daniel Mensah, Elvis A Okolie, Olalekan A Uthman, Oyinlola O Oyebode, Equity of national publicly funded health insurance schemes under the universal health coverage agenda: a systematic review of studies conducted in Africa, Journal of Public Health, 2021;, fdab316, is available online at: https://doi.org/10.1093/pubmed/fdab316 | |||||||||
| Access rights to Published version: | Restricted or Subscription Access | |||||||||
| Copyright Holders: | © The Author(s) 2021. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com | |||||||||
| Date of first compliant deposit: | 17 September 2021 | |||||||||
| Date of first compliant Open Access: | 14 August 2022 | |||||||||
| RIOXX Funder/Project Grant: |
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