The effect of health insurance on maternal and child health: A systematic review

Abstract

Background: There has been increased interest in improving access of the rural poor to essential healthcare through community-based health insurance schemes to create an alternative from the dominant OOP expenditure being currently experienced. Aim: We performed a systematic review with the aim to determine the global effect of health insurance systems on maternal and child health. Methods: A search for primary studies reporting on the effect of health insurance on maternal and child health was done. Results: Eight articles met the inclusion criteria with four of them from low-income countries. We found that the cesarean section rates (P = 0.01) and proportion of women with low birth weight babies (P < 0.0001) were statistically significantly better in the insured women. However, the prevalence of (pre)eclampsia, the proportion of women with anemia/excessive blood loss at delivery, and mean birth weight at delivery were similar between the insured and uninsured women (P > 0.05). The risk of wasting among insured children was also reduced, although not statistically significant (P = 0.26). Conclusions: The findings suggest that health insurance probably has a beneficial effect in reducing the number of low birth weight babies born. Insurance also seems to reduce the risk for cesarean section. More research on the impact of health insurance on both maternal and child health outcomes need to be done to further establish these outcomes.