Utilization of Antenatal Care and Health Insurance: Evidence from Demographic and Health Survey Data

Antenatal care check-ups play a critical role in monitoring the health of pregnant women and their unborn children, providing vital healthcare education, routine screenings, and early intervention for potential complications. However, due to financial barriers, few expectant mothers attend the recommended eight or more visits advised by the World Health Organization. Consequently, maternal mortality rates remain alarmingly high. This study estimates how health insurance coverage affects the patterns of antenatal care attendance among pregnant women in Nigeria. This study utilizes data from the 2018 Nigerian Demographic and Health Survey, comprising a sample of 13,311 mothers aged 17 to 59. Specifically, data on antenatal care and health insurance coverage among young mothers in Nigeria are analyzed. The study applies descriptive statistics and a binary logistic regression model to examine the relationship between health insurance access and antenatal care participation. The binary logistic model is chosen for its effectiveness in estimating the probability of a dichotomous outcome based on multiple explanatory variables. Approximately 80% of pregnant women attended antenatal care during their last childbirth, while only 3.4% had health insurance coverage, in contrast to 96.6% who did not. The findings show that health insurance coverage had limited influence on the use of antenatal care compared to those without health insurance (OR = 1.354, 95% CI = 1.168-1.575), indicating that other factors may play a more decisive role. Specifically, higher educational attainment, elevated wealth status, and being in a marital union significantly increased the likelihood of antenatal care usage in Nigeria. The study concludes that, while health insurance remains a critical component, a broader, multi-faceted strategy is essential for advancing maternal healthcare in Nigeria. Among its recommendations is a review of the current health insurance policy and its administration, with an emphasis on enhancing access for antenatal care seekers. Such reforms are vital for improving both maternal and child health indicators nationwide.