Uptake of health insurance in Malawi in 2019-2020: Evidence from the Multiple Indicator Cluster Survey

Abstract

Introduction: Although countries in sub-Sahara Africa (SSA) show progress in implementing various forms of health insurance, there is a dearth of information regarding health insurance in settings like Malawi. Therefore, we conducted this study to determine the uptake of health insurance and describe some of the factors associated with the prevailing uptake of health insurance in Malawi using the 2019-20 Multiple Indicator Cluster Survey (MICS). Methods: This was a secondary analysis of the 2019-20 MICS data. Data were analysed using frequencies and weighted percentages in Stata v.17. Furthermore, since the number of persons with health insurance is very small, we were unable to perform multivariate analysis. Results: A total of 205 (1%) of the 31259 had health insurance in Malawi in 2019-20. Of the 205 individuals that owned health insurance, 118 (47%) had health insurance through their employers while 39 (16%) had health insurance through mutual health organization or ccommunity-based. Men had higher uptake of health insurance than the women. The residents from urban areas were more likely to have a health insurance than those in the rural areas. Persons with media exposure were more likely to own health insurance as compared to their counterparts. There was increasing trend in the uptake of health insurance by wealth of the individual with the poorest being less likely to have health insurance compared to the richest. The persons with no education being least likely to have a health insurance while those with tertiary education were most likely to have health insurance. Conclusion: The uptake of health insurance in Malawi was extremely low. In order to increase the uptake of health insurance, there is need to increase insurance coverage amongst those in formal employment, consider minimizing the geographic, economic and demographic barriers in accessing the health insurance.