Description
- Abstract:
- Background: In an effort to combat inequitable access to healthcare in Tanzania, President Samia Hassan signed the Tanzania Universal Healthcare Act (2023) that requires all citizens to have health insurance (Osoro et al., 2023). Currently Tanzania has extremely low insurance coverage with an estimated 15.3% of the population covered, leading many families to pay for healthcare services out of pocket including pregnancy and delivery services (Kowalewski et al., 2002; MoH 2003; Osoro et al., 2023). In Tanzania specifically, it remains unclear to what extent insurance increases accessibility to quality biomedical care for mothers (Kuwawenaruwa et al., 2019; MoH 2003). The purpose of this study is to examine the association between health insurance and delivering in a biomedical facility among women in Tanzania. Methods: I use STATA Version 18.0 to analyze Demographic Health Survey (DHS) data from 2022 and 2015-2016 to run logistic regressions. The DHS conducts household and individual surveys through randomly selected households all over the country to make it nationally representative. I merged data from the women’s individual survey and the pregnancy and birth recode dataset. The analytic sample for 2022 is 2,127 births and for 2015-2016 is 2,021, after removing ineligible births not occurring in the last year and missing information. Results: The unadjusted odds of delivering in a biomedical facility for women with insurance is 2.42 (1.44, 4.07) and 3.12 (1.28, 7.61) times the odds of women that do not have insurance for 2015-2016 and 2022 respectively. The odds ratio remains significant when adjusted for the following variables: antenatal care, age, and marital status. The adjusted odds of delivering in a biomedical facility for women with insurance is 2.40 (1.41, 4.08) and 2.87 (1.25, 6.59) times the odds of delivering in a biomedical facility compared to women without insurance, holding all else constant, for 2015-2016 and 2022 respectively. The variables for educational attainment and bank account are highly correlated with insurance status acting as confounders, so they are removed from the model. Conclusion: This study demonstrates importance of insurance in increasing healthcare utilization for delivery in Tanzania.
- Notes:
- Thesis (M. P. H.)--Brown University, 2026
Citation
Schultz, Isabella,
"A Study on the Relationship between Health Insurance and Facility Births in Tanzania"
(2026).
Public Health Theses and Dissertations.
Brown Digital Repository. Brown University Library.
https://repository.library.brown.edu/studio/item/bdr:hcg7en47/
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Public Health Theses and Dissertations
Theses and Dissertations for the Public Health department....