Distance and health facility choice: Evidence from a health micro insurance program in Punjab, Pakistan

Latif, Dareen; Ahmed, Hamna

doi:10.1002/hpm.3547

Cited by 2 publications

(1 citation statement)

References 64 publications

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“…Given the high transportation costs coupled with poor road infrastructure, spending a longer time to reach health facilities might have led to dissatisfaction among the insured. Studies have shown that people would prefer private health facilities with no insurance service despite their high cost rather than traveling longer distances [43][44][45][46]. Similar to this finding, a study conducted in Nigeria revealed physical accessibility to health facilities as an important factor leading to higher user satisfaction [47].…”

Section: Plos Onementioning

confidence: 56%

User satisfaction with the National Health Insurance Program: A community-based survey from the Ilam district of Nepal

Shrestha,

Shakya,

Khanal

et al. 2024

PLoS ONE

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Background The Government of Nepal initiated a family-based National Health Insurance Program (NHIP) in April 2016, aiming to ensure universal health coverage (UHC) by enhancing access to and utilization of quality health services. However, NHIP, in its initial years of implementation, encountered challenges such as low population coverage, a high dropout rate, and concerns among the insured regarding the quality of healthcare services. There is a dearth of information regarding user satisfaction with the NHIP in Nepal. This study aimed to assess user satisfaction with NHIP at the household level in Nepal. Methods We conducted a cross-sectional study among 347 households in the Ilam district using a multi-stage random sampling method. Face-to-face interviews were conducted with household heads enrolled in NHIP. A semi-structured questionnaire was used to collect the data. The multivariable logistic regression analysis was done to identify the predictors of satisfaction level. Results Overall, 53.6% of the insured were satisfied with the NHIP, while 31.1% had comprehensive knowledge about the NHIP. Factors such as gender (AOR: 1.80, 95% CI: 1.08–3.00), distance to the first point of contact (AOR: 2.15, 95% CI: 1.24–3.74), waiting time (AOR: 2.02, 95% CI: 1.20–3.42), availability of diagnostic services (AOR: 1.90, 95% CI: 1.05–3.45), availability of prescribed medicine (AOR: 3.90, 95% CI: 1.97–7.69), perceived service quality (AOR: 2.20, 95% CI: 1.15–4.20), and the behavior of service providers (AOR: 3.48, 95% CI: 1.04–11.63) were significantly associated with user satisfaction. Conclusion The satisfaction level among NHIP users was deemed moderate. This study highlighted several factors, such as gender, distance to the first point of contact, waiting time, availability of diagnostic services and prescribed medicine, perceived service quality, and the behavior of service providers, as key determinants impacting user satisfaction. Recognizing the pivotal role of user satisfaction, health insurance stakeholders must prioritize it to ensure higher retention rates and coverage within NHIP.

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Section: Plos Onementioning

confidence: 56%

User satisfaction with the National Health Insurance Program: A community-based survey from the Ilam district of Nepal

Shrestha,

Shakya,

Khanal

et al. 2024

PLoS ONE

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Financing for equity for women’s, children’s and adolescents’ health in low- and middle-income countries: A scoping review

Bou-Karroum,

Iaia,

El-Jardali

et al. 2024

PLOS Glob Public Health

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Over the past few decades, the world has witnessed considerable progress in women’s, children’s and adolescents’ health (WCAH) and the Sustainable Development Goals (SDGs). Yet deep inequities remain between and within countries. This scoping review aims to map financing interventions and measures to improve equity in WCAH in low- and middle-income countries (LMICs). This scoping review was conducted following Joanna Briggs Institute (JBI) guidance for conducting such reviews as well as the PRISMA Extension for Scoping Reviews (PRISMA-ScR) for reporting scoping reviews. We searched Medline, PubMed, EMBASE and the World Health Organization’s (WHO) Global Index Medicus, and relevant websites. The selection process was conducted in duplicate and independently. Out of 26 355 citations identified from electronic databases, relevant website searches and stakeholders’ consultations, 413 studies were included in the final review. Conditional cash transfers (CCTs) (22.3%), health insurance (21.4%), user fee exemptions (18.1%) and vouchers (16.9%) were the most reported financial interventions and measures. The majority were targeted at women (57%) and children (21%) with others targeting adolescents (2.7%) and newborns (0.7%). The findings highlighted that CCTs, voucher programs and various insurance schemes can improve the utilization of maternal and child health services for the poor and the disadvantaged, and improve mortality and morbidity rates. However, multiple implementation challenges impact the effectiveness of these programmes. Some studies suggested that financial interventions alone would not be sufficient to achieve equity in health coverage among those of a lower income and those residing in remote regions. This review provides evidence on financing interventions to address the health needs of the most vulnerable communities. It can be used to inform the design of equitable health financing policies and health system reform efforts that are essential to moving towards universal health coverage (UHC). By also unveiling the knowledge gaps, it can be used to inform future research on financing interventions and measures to improve equity when addressing WCAH in LMICs.

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Distance and health facility choice: Evidence from a health micro insurance program in Punjab, Pakistan

Cited by 2 publications

References 64 publications

User satisfaction with the National Health Insurance Program: A community-based survey from the Ilam district of Nepal

User satisfaction with the National Health Insurance Program: A community-based survey from the Ilam district of Nepal

Financing for equity for women’s, children’s and adolescents’ health in low- and middle-income countries: A scoping review

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