Women's Health Insurance Status in Senegal West Africa

Background: Senegalese women of childbearing age continue to be disproportionately affected by communicable and noncommunicable disease, yet still face reduced health care access despite the expanding coverage of universal health insurance schemes. There is need to understand the role of women’s socio-demographic positioning and household decision-making autonomy on their health care insurance participation. Method: We analyzed data from a representative sample from the 2016 Senegalese Demographic and Health Surveys (DHS) using logistic regression models to examine the association between women’s insurance coverage and socio-demographic correlates including women’s household decision making autonomy. Results: The final study sample included a total of 1308 Senegalese women (age extremes: 15 and 49 years). Most women were 30 to 34 years (23.6%), did not have any formal education (59.4%), could not read at all (67%) and did not have health insurance (89.3%). Socio-demographic factors were significantly associated with health insurance enrollment. The probability of being enrolled in health insurance was 16.4 percentage points higher among women with the greatest wealth, as compared to those with the least wealth (95% confidence interval, 9.7 to 23.1). The probability of being enrolled in health insurance was 5.9 percentage points higher among women with any education, as compared to those with no education (95% confidence interval, 0.7 to 11.1). Household decision-making autonomy was not associated with insurance coverage. Conclusion: Our study not only highlights the disparities in health insurance uptake in this population but also suggests a need for studies, especially among women in resourcelimited households, that shed light on how to best design, market, and improve uptake of health insurance among women.