Beneficiaries’ satisfaction with health insurance and associated factors in Sub-Saharan Africa: a systematic review and meta-analysis
Objective Beneficiaries’ satisfaction with health insurance schemes is crucial for the success of these programmes, influencing their effective implementation and reducing dropout rates. This systematic review and meta-analysis aimed to assess the proportion of beneficiaries satisfied with health in...
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BMJ Publishing Group
2025-02-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/15/2/e089029.full |
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| author | Abubeker Alebachew Seid Bizunesh Fantahun Kase Abdu Hailu Shibeshi Molla Getie Mehari Abdulkerim Hassen Moloro |
| author_facet | Abubeker Alebachew Seid Bizunesh Fantahun Kase Abdu Hailu Shibeshi Molla Getie Mehari Abdulkerim Hassen Moloro |
| author_sort | Abubeker Alebachew Seid |
| collection | DOAJ |
| description | Objective Beneficiaries’ satisfaction with health insurance schemes is crucial for the success of these programmes, influencing their effective implementation and reducing dropout rates. This systematic review and meta-analysis aimed to assess the proportion of beneficiaries satisfied with health insurance and identify factors associated with their satisfaction in Sub-Saharan Africa (SSA).Design A systematic review and meta-analysis were conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-analysis guidelines.Data sources PubMed/MEDLINE, African Journals Online, Cumulative Index to Nursing & Allied Health Literature and Google Scholar were searched up to 23 May 2024.Eligibility criteria Observational and quantitative studies conducted in SSA that reported the proportion of health insurance beneficiaries satisfied with the scheme and/or determined factors associated with satisfaction were included.Data extraction and synthesis Data were extracted using Microsoft Excel and analysed with STATA V.17 software. The quality of studies was assessed using Joanna Briggs Institute checklists. A random-effects model was employed to estimate pooled outcomes. Publication bias was evaluated with a funnel plot and Egger’s regression test, while heterogeneity was assessed using the I² statistic.Result The study included 29 primary studies with a total of 11,488 participants. Among the included studies, 17 (58.62%) were found to have a low risk of bias, while the remaining studies exhibited a moderate risk of bias. The findings suggested publication bias among the included studies. To address this, a trim-and-fill analysis imputed 10 hypothetical missing studies, resulting in a more symmetrical funnel plot. The pooled finding showed that 61.84% of beneficiaries were satisfied with their health insurance (95% CI: 55.14 to 68.55, (I2=98.6%, p<0.001)). Having a good knowledge of health insurance (OR=2.75, 95% CI: 1.42 to 5.34, (I2=95.3%, p<0.001)), availability of prescribed drugs (OR=5.69, 95% CI: 3.04 to 10.62, (I2=88.6%, p<0.001)) and availability of lab services (OR=4.20, 95% CI: 2.18 to 8.11, (I2=88.4%, p<0.001)) were significantly associated to higher satisfaction with health insurance.Conclusion The results of this review show that a significant number of beneficiaries are satisfied with their health insurance. The findings highlight that beneficiaries’ satisfaction is significantly influenced by their knowledge of health insurance, as well as the availability of prescribed drugs and essential laboratory services. It is recommended that health insurance programmes in SSA focus on these factors to improve overall satisfaction among beneficiaries.PROSPERO registration number CRD42024496847. |
| format | Article |
| id | doaj-art-373e214affa14683ae87f6ed4384a904 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2025-02-01 |
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| series | BMJ Open |
| spelling | doaj-art-373e214affa14683ae87f6ed4384a9042025-02-08T07:10:10ZengBMJ Publishing GroupBMJ Open2044-60552025-02-0115210.1136/bmjopen-2024-089029Beneficiaries’ satisfaction with health insurance and associated factors in Sub-Saharan Africa: a systematic review and meta-analysisAbubeker Alebachew Seid0Bizunesh Fantahun Kase1Abdu Hailu Shibeshi2Molla Getie Mehari3Abdulkerim Hassen Moloro43 Department of Nursing, College of Medicine and Health Sciences, Samara University, Semera, Ethiopia1 Department of Public Health, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia2 Department of Statistics, College of Natural and Computational Sciences, Samara University, Samara, Ethiopia4 Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia3 Department of Nursing, College of Medicine and Health Sciences, Samara University, Semera, EthiopiaObjective Beneficiaries’ satisfaction with health insurance schemes is crucial for the success of these programmes, influencing their effective implementation and reducing dropout rates. This systematic review and meta-analysis aimed to assess the proportion of beneficiaries satisfied with health insurance and identify factors associated with their satisfaction in Sub-Saharan Africa (SSA).Design A systematic review and meta-analysis were conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-analysis guidelines.Data sources PubMed/MEDLINE, African Journals Online, Cumulative Index to Nursing & Allied Health Literature and Google Scholar were searched up to 23 May 2024.Eligibility criteria Observational and quantitative studies conducted in SSA that reported the proportion of health insurance beneficiaries satisfied with the scheme and/or determined factors associated with satisfaction were included.Data extraction and synthesis Data were extracted using Microsoft Excel and analysed with STATA V.17 software. The quality of studies was assessed using Joanna Briggs Institute checklists. A random-effects model was employed to estimate pooled outcomes. Publication bias was evaluated with a funnel plot and Egger’s regression test, while heterogeneity was assessed using the I² statistic.Result The study included 29 primary studies with a total of 11,488 participants. Among the included studies, 17 (58.62%) were found to have a low risk of bias, while the remaining studies exhibited a moderate risk of bias. The findings suggested publication bias among the included studies. To address this, a trim-and-fill analysis imputed 10 hypothetical missing studies, resulting in a more symmetrical funnel plot. The pooled finding showed that 61.84% of beneficiaries were satisfied with their health insurance (95% CI: 55.14 to 68.55, (I2=98.6%, p<0.001)). Having a good knowledge of health insurance (OR=2.75, 95% CI: 1.42 to 5.34, (I2=95.3%, p<0.001)), availability of prescribed drugs (OR=5.69, 95% CI: 3.04 to 10.62, (I2=88.6%, p<0.001)) and availability of lab services (OR=4.20, 95% CI: 2.18 to 8.11, (I2=88.4%, p<0.001)) were significantly associated to higher satisfaction with health insurance.Conclusion The results of this review show that a significant number of beneficiaries are satisfied with their health insurance. The findings highlight that beneficiaries’ satisfaction is significantly influenced by their knowledge of health insurance, as well as the availability of prescribed drugs and essential laboratory services. It is recommended that health insurance programmes in SSA focus on these factors to improve overall satisfaction among beneficiaries.PROSPERO registration number CRD42024496847.https://bmjopen.bmj.com/content/15/2/e089029.full |
| spellingShingle | Abubeker Alebachew Seid Bizunesh Fantahun Kase Abdu Hailu Shibeshi Molla Getie Mehari Abdulkerim Hassen Moloro Beneficiaries’ satisfaction with health insurance and associated factors in Sub-Saharan Africa: a systematic review and meta-analysis BMJ Open |
| title | Beneficiaries’ satisfaction with health insurance and associated factors in Sub-Saharan Africa: a systematic review and meta-analysis |
| title_full | Beneficiaries’ satisfaction with health insurance and associated factors in Sub-Saharan Africa: a systematic review and meta-analysis |
| title_fullStr | Beneficiaries’ satisfaction with health insurance and associated factors in Sub-Saharan Africa: a systematic review and meta-analysis |
| title_full_unstemmed | Beneficiaries’ satisfaction with health insurance and associated factors in Sub-Saharan Africa: a systematic review and meta-analysis |
| title_short | Beneficiaries’ satisfaction with health insurance and associated factors in Sub-Saharan Africa: a systematic review and meta-analysis |
| title_sort | beneficiaries satisfaction with health insurance and associated factors in sub saharan africa a systematic review and meta analysis |
| url | https://bmjopen.bmj.com/content/15/2/e089029.full |
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