Abstract:

Maternal mortality remains a leading cause of death among women of reproductive age group. This study determined the cost of antenatal care among Health Insurance (HI) enrollees and Out-of-Pocket (OOP) payers accessing maternal healthcare services in a tertiary health institution in Southwest Nigeria. A comparative cross-sectional study was carried out among 380 women (190 HI enrollees and 190 OOP payers) attending antenatal care services in a tertiary health institution in Southwest Nigeria using a systematic random sampling technique. Data was gathered using an interviewer-administered semi-structured questionnaire and analyzed using IBM SPSS version 23. Chi-square and binary logistic regression were used to assess the association between dependent and independent variables and a P-value of <0.05 was taken as significant. The overall mean age of respondents in this study was 33.8 ± 5.0 years (HI Group: 34.1 ± 4.9 years and OOP Group: 33.6 ± 5.0 years). The mean total cost of Antenatal Care (ANC) is lesser for HI enrollees (₦5,095.2 ± 1,753.1 equivalent to $13.3 ± 4.6) as compared with OOP payers (₦15,050.6 ± 5,548.9 equivalent to $39.6 ± 14.6). Predictors and enablers for HI uptake are marital status, family size, level of education, occupation, appropriate and quality HI package, and trust in the HI scheme. It was concluded that the total cost of antenatal care is lower among the Health Insurance enrollees than the Out-of-Pocket payers. Therefore, interventions to increase awareness and designing more enticing HI packages are recommended.

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