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Health Insurance Coverage and Its Socioeconomic and Demographic Determinants in Cameroon

Received: 1 June 2023    Accepted: 25 June 2023    Published: 6 July 2023
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Abstract

Health insurance coverage is a public health issue for global and national health financing in Africa where countries have gradually begun to implement universal health coverage. This study analyses the socioeconomic and demographic determinants of health insurance coverage in Cameroon using a cross-sectional study design. A nationwide stratified, two-stage sampling was used to sample 33,983 individuals. A logistic regression model was used for both bivariate and multivariate analysis with a statistically significant level of p<0.05. The participants were predominantly male (77%) with a sex ratio of 3.3. The health insurance coverage rate was only 2.06% of people. Urban residents were significantly more likely to be covered (1.54%) compared to rural residents (0.51%; p<0.00). Men (1.52%) were significantly more covered than women (0.54%; p<0.04) and both sexes were cumulatively split between employer health insurance (54.94%), social security (22%), mutual health insurance (12.2%), private commercial insurance (10%) and help/relief from associations/family (0.87%). Working age influences insurance coverage with statistically significant differences among age groups (0.15%, 0.67%, and 1.23%, p<0.00). A high level of education significantly increases insurance coverage with 82.5% of secondary and tertiary education compared to 17.5% for primary and no education (p<0.00). The economic well-being quintile scale influences the susceptibility to health insurance coverage with 76.4% of the rich and/or richer, compared to 13.6% of the middle class, 10% of the poor, and none of the poorest (p<0.00). Compared to the rich, the poorest were 78%, the poor 75%, and the middle class 67%, less likely to be covered by any type of health insurance (p<0.01). Employability positively influences health insurance coverage with statistically significant differences between annual full-time workers (77.6%), seasonal workers (13.6%), and casual workers (8.8%, p<0.00). These findings provided evidence to guide policies for improving equity in financing universal health coverage for people living in low-resource settings.

Published in International Journal of Health Economics and Policy (Volume 8, Issue 2)
DOI 10.11648/j.hep.20230802.13
Page(s) 44-56
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Health Insurance, Coverage, Determinants, Socioeconomic, Demographic, Universal Health Coverage, Cameroon

References
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    Zakariaou Njoumemi, Altiné Fadimatou, Samuel Honore Ntavoua, Ousseni Mongbet, Rahimatou Manouore. (2023). Health Insurance Coverage and Its Socioeconomic and Demographic Determinants in Cameroon. International Journal of Health Economics and Policy, 8(2), 44-56. https://doi.org/10.11648/j.hep.20230802.13

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    Zakariaou Njoumemi; Altiné Fadimatou; Samuel Honore Ntavoua; Ousseni Mongbet; Rahimatou Manouore. Health Insurance Coverage and Its Socioeconomic and Demographic Determinants in Cameroon. Int. J. Health Econ. Policy 2023, 8(2), 44-56. doi: 10.11648/j.hep.20230802.13

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    AMA Style

    Zakariaou Njoumemi, Altiné Fadimatou, Samuel Honore Ntavoua, Ousseni Mongbet, Rahimatou Manouore. Health Insurance Coverage and Its Socioeconomic and Demographic Determinants in Cameroon. Int J Health Econ Policy. 2023;8(2):44-56. doi: 10.11648/j.hep.20230802.13

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  • @article{10.11648/j.hep.20230802.13,
      author = {Zakariaou Njoumemi and Altiné Fadimatou and Samuel Honore Ntavoua and Ousseni Mongbet and Rahimatou Manouore},
      title = {Health Insurance Coverage and Its Socioeconomic and Demographic Determinants in Cameroon},
      journal = {International Journal of Health Economics and Policy},
      volume = {8},
      number = {2},
      pages = {44-56},
      doi = {10.11648/j.hep.20230802.13},
      url = {https://doi.org/10.11648/j.hep.20230802.13},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.hep.20230802.13},
      abstract = {Health insurance coverage is a public health issue for global and national health financing in Africa where countries have gradually begun to implement universal health coverage. This study analyses the socioeconomic and demographic determinants of health insurance coverage in Cameroon using a cross-sectional study design. A nationwide stratified, two-stage sampling was used to sample 33,983 individuals. A logistic regression model was used for both bivariate and multivariate analysis with a statistically significant level of p<0.05. The participants were predominantly male (77%) with a sex ratio of 3.3. The health insurance coverage rate was only 2.06% of people. Urban residents were significantly more likely to be covered (1.54%) compared to rural residents (0.51%; p<0.00). Men (1.52%) were significantly more covered than women (0.54%; p<0.04) and both sexes were cumulatively split between employer health insurance (54.94%), social security (22%), mutual health insurance (12.2%), private commercial insurance (10%) and help/relief from associations/family (0.87%). Working age influences insurance coverage with statistically significant differences among age groups (0.15%, 0.67%, and 1.23%, p<0.00). A high level of education significantly increases insurance coverage with 82.5% of secondary and tertiary education compared to 17.5% for primary and no education (p<0.00). The economic well-being quintile scale influences the susceptibility to health insurance coverage with 76.4% of the rich and/or richer, compared to 13.6% of the middle class, 10% of the poor, and none of the poorest (p<0.00). Compared to the rich, the poorest were 78%, the poor 75%, and the middle class 67%, less likely to be covered by any type of health insurance (p<0.01). Employability positively influences health insurance coverage with statistically significant differences between annual full-time workers (77.6%), seasonal workers (13.6%), and casual workers (8.8%, p<0.00). These findings provided evidence to guide policies for improving equity in financing universal health coverage for people living in low-resource settings.},
     year = {2023}
    }
    

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  • TY  - JOUR
    T1  - Health Insurance Coverage and Its Socioeconomic and Demographic Determinants in Cameroon
    AU  - Zakariaou Njoumemi
    AU  - Altiné Fadimatou
    AU  - Samuel Honore Ntavoua
    AU  - Ousseni Mongbet
    AU  - Rahimatou Manouore
    Y1  - 2023/07/06
    PY  - 2023
    N1  - https://doi.org/10.11648/j.hep.20230802.13
    DO  - 10.11648/j.hep.20230802.13
    T2  - International Journal of Health Economics and Policy
    JF  - International Journal of Health Economics and Policy
    JO  - International Journal of Health Economics and Policy
    SP  - 44
    EP  - 56
    PB  - Science Publishing Group
    SN  - 2578-9309
    UR  - https://doi.org/10.11648/j.hep.20230802.13
    AB  - Health insurance coverage is a public health issue for global and national health financing in Africa where countries have gradually begun to implement universal health coverage. This study analyses the socioeconomic and demographic determinants of health insurance coverage in Cameroon using a cross-sectional study design. A nationwide stratified, two-stage sampling was used to sample 33,983 individuals. A logistic regression model was used for both bivariate and multivariate analysis with a statistically significant level of p<0.05. The participants were predominantly male (77%) with a sex ratio of 3.3. The health insurance coverage rate was only 2.06% of people. Urban residents were significantly more likely to be covered (1.54%) compared to rural residents (0.51%; p<0.00). Men (1.52%) were significantly more covered than women (0.54%; p<0.04) and both sexes were cumulatively split between employer health insurance (54.94%), social security (22%), mutual health insurance (12.2%), private commercial insurance (10%) and help/relief from associations/family (0.87%). Working age influences insurance coverage with statistically significant differences among age groups (0.15%, 0.67%, and 1.23%, p<0.00). A high level of education significantly increases insurance coverage with 82.5% of secondary and tertiary education compared to 17.5% for primary and no education (p<0.00). The economic well-being quintile scale influences the susceptibility to health insurance coverage with 76.4% of the rich and/or richer, compared to 13.6% of the middle class, 10% of the poor, and none of the poorest (p<0.00). Compared to the rich, the poorest were 78%, the poor 75%, and the middle class 67%, less likely to be covered by any type of health insurance (p<0.01). Employability positively influences health insurance coverage with statistically significant differences between annual full-time workers (77.6%), seasonal workers (13.6%), and casual workers (8.8%, p<0.00). These findings provided evidence to guide policies for improving equity in financing universal health coverage for people living in low-resource settings.
    VL  - 8
    IS  - 2
    ER  - 

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Author Information
  • Department of Public Health, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon

  • Department of Public Health, Faculty of Medicine and Biomedical Sciences, University of Garoua, Garoua, Cameron

  • Policy and Programme Analysis Division, Health Economics and Policy Research and Evaluation for Development Results Group (HEREG), Yaounde, Cameroon

  • Policy and Programme Analysis Division, Health Economics and Policy Research and Evaluation for Development Results Group (HEREG), Yaounde, Cameroon

  • Policy and Programme Analysis Division, Health Economics and Policy Research and Evaluation for Development Results Group (HEREG), Yaounde, Cameroon

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