Protective role of health insurance coverage in reducing under-five mortality in Ethiopia: Gompertz inverse-Gaussian shared frailty modelling
Objective To determine the association between health insurance coverage and under-five mortality in Ethiopia using data from the 2016 Ethiopia Demographic and Health Survey (EDHS).Methods The current study used a total of 10 641 under-five children from the 2016 EDHS. To identify the predictors, th...
Saved in:
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2025-03-01
|
| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/15/3/e095665.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850261948691644416 |
|---|---|
| author | Yordanos Sisay Asgedom Beminate Lemma Seifu Kusse Urmale Mare Tsion Mulat Tebeje Afework Alemu Bezawit Melak Fente Zufan Alamrie Asmare Hiwot Altaye Asebe Bizunesh Fantahun Kase Abdu Hailu Shibeshi Kebede Gemeda Sabo |
| author_facet | Yordanos Sisay Asgedom Beminate Lemma Seifu Kusse Urmale Mare Tsion Mulat Tebeje Afework Alemu Bezawit Melak Fente Zufan Alamrie Asmare Hiwot Altaye Asebe Bizunesh Fantahun Kase Abdu Hailu Shibeshi Kebede Gemeda Sabo |
| author_sort | Yordanos Sisay Asgedom |
| collection | DOAJ |
| description | Objective To determine the association between health insurance coverage and under-five mortality in Ethiopia using data from the 2016 Ethiopia Demographic and Health Survey (EDHS).Methods The current study used a total of 10 641 under-five children from the 2016 EDHS. To identify the predictors, the Gompertz inverse-Gaussian shared frailty model was fitted. The theta value, Akaike Information Criteria and Bayesian Information Criteria were applied for model evaluation, and variables with p values less than 0.2 were included in the multivariable analysis. The strength and statistical significance of the associations were demonstrated by reporting the adjusted HR (AHR) with a 95% CI in the multivariable Gompertz inverse-Gaussian shared frailty model.Results According to the study’s findings, 96.46% of the children were born to mothers not covered by health insurance. The study found that health insurance coverage was significantly associated with a lower risk of under-five mortality (not covered: AHR=0.13; 95% CI 0.02, 0.95). Other factors that showed significant associations with under-five mortality include place of residency, family size, twin status, place of delivery and preceding birth interval.Conclusion The findings indicate that health insurance coverage in Ethiopia is significantly associated with a lower risk of mortality among children under five. However, coverage remains low among mothers of these children, highlighting an urgent need for policies and interventions aimed at expanding health insurance coverage and addressing key determinants of child health to reduce under-five mortality and improve child survival outcomes. Addressing gaps in health insurance and other contributing factors is vital for creating effective strategies to lower under-five mortality rates. |
| format | Article |
| id | doaj-art-67cdfe8b274d487a8c5094c32dd9e88b |
| institution | OA Journals |
| issn | 2044-6055 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-67cdfe8b274d487a8c5094c32dd9e88b2025-08-20T01:55:18ZengBMJ Publishing GroupBMJ Open2044-60552025-03-0115310.1136/bmjopen-2024-095665Protective role of health insurance coverage in reducing under-five mortality in Ethiopia: Gompertz inverse-Gaussian shared frailty modellingYordanos Sisay Asgedom0Beminate Lemma Seifu1Kusse Urmale Mare2Tsion Mulat Tebeje3Afework Alemu4Bezawit Melak Fente5Zufan Alamrie Asmare6Hiwot Altaye Asebe7Bizunesh Fantahun Kase8Abdu Hailu Shibeshi9Kebede Gemeda Sabo10Department of Epidemiology and Biostatics, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, EthiopiaDepartment of Public Health, College of Medicine and Health Sciences, Samara University, Samara, EthiopiaDepartment of Nursing, College of Medicine and Health Sciences, Samara University, Samara, EthiopiaSchool of Public Health, College of Health sciences and Medicine, Dilla University, Dilla, EthiopiaSchool of Medicine, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, EthiopiaDepartment of General Midwifery, School of Midwifery, College of Medicine & Health sciences, University of Gondar, Gondar, EthiopiaDepartment of Ophthalmology, School of Medicine and Health Sciences, Debre Tabor University, Debre Tabor, EthiopiaDepartment of Public Health, College of Medicine and Health Sciences, Samara University, Samara, EthiopiaDepartment of Public Health, College of Medicine and Health Sciences, Samara University, Samara, EthiopiaDepartment of Statistics, College of Natural and Computational Sciences, Samara University, Samara, EthiopiaDepartment of Nursing, College of Medicine and Health Sciences, Samara University, Samara, EthiopiaObjective To determine the association between health insurance coverage and under-five mortality in Ethiopia using data from the 2016 Ethiopia Demographic and Health Survey (EDHS).Methods The current study used a total of 10 641 under-five children from the 2016 EDHS. To identify the predictors, the Gompertz inverse-Gaussian shared frailty model was fitted. The theta value, Akaike Information Criteria and Bayesian Information Criteria were applied for model evaluation, and variables with p values less than 0.2 were included in the multivariable analysis. The strength and statistical significance of the associations were demonstrated by reporting the adjusted HR (AHR) with a 95% CI in the multivariable Gompertz inverse-Gaussian shared frailty model.Results According to the study’s findings, 96.46% of the children were born to mothers not covered by health insurance. The study found that health insurance coverage was significantly associated with a lower risk of under-five mortality (not covered: AHR=0.13; 95% CI 0.02, 0.95). Other factors that showed significant associations with under-five mortality include place of residency, family size, twin status, place of delivery and preceding birth interval.Conclusion The findings indicate that health insurance coverage in Ethiopia is significantly associated with a lower risk of mortality among children under five. However, coverage remains low among mothers of these children, highlighting an urgent need for policies and interventions aimed at expanding health insurance coverage and addressing key determinants of child health to reduce under-five mortality and improve child survival outcomes. Addressing gaps in health insurance and other contributing factors is vital for creating effective strategies to lower under-five mortality rates.https://bmjopen.bmj.com/content/15/3/e095665.full |
| spellingShingle | Yordanos Sisay Asgedom Beminate Lemma Seifu Kusse Urmale Mare Tsion Mulat Tebeje Afework Alemu Bezawit Melak Fente Zufan Alamrie Asmare Hiwot Altaye Asebe Bizunesh Fantahun Kase Abdu Hailu Shibeshi Kebede Gemeda Sabo Protective role of health insurance coverage in reducing under-five mortality in Ethiopia: Gompertz inverse-Gaussian shared frailty modelling BMJ Open |
| title | Protective role of health insurance coverage in reducing under-five mortality in Ethiopia: Gompertz inverse-Gaussian shared frailty modelling |
| title_full | Protective role of health insurance coverage in reducing under-five mortality in Ethiopia: Gompertz inverse-Gaussian shared frailty modelling |
| title_fullStr | Protective role of health insurance coverage in reducing under-five mortality in Ethiopia: Gompertz inverse-Gaussian shared frailty modelling |
| title_full_unstemmed | Protective role of health insurance coverage in reducing under-five mortality in Ethiopia: Gompertz inverse-Gaussian shared frailty modelling |
| title_short | Protective role of health insurance coverage in reducing under-five mortality in Ethiopia: Gompertz inverse-Gaussian shared frailty modelling |
| title_sort | protective role of health insurance coverage in reducing under five mortality in ethiopia gompertz inverse gaussian shared frailty modelling |
| url | https://bmjopen.bmj.com/content/15/3/e095665.full |
| work_keys_str_mv | AT yordanossisayasgedom protectiveroleofhealthinsurancecoverageinreducingunderfivemortalityinethiopiagompertzinversegaussiansharedfrailtymodelling AT beminatelemmaseifu protectiveroleofhealthinsurancecoverageinreducingunderfivemortalityinethiopiagompertzinversegaussiansharedfrailtymodelling AT kusseurmalemare protectiveroleofhealthinsurancecoverageinreducingunderfivemortalityinethiopiagompertzinversegaussiansharedfrailtymodelling AT tsionmulattebeje protectiveroleofhealthinsurancecoverageinreducingunderfivemortalityinethiopiagompertzinversegaussiansharedfrailtymodelling AT afeworkalemu protectiveroleofhealthinsurancecoverageinreducingunderfivemortalityinethiopiagompertzinversegaussiansharedfrailtymodelling AT bezawitmelakfente protectiveroleofhealthinsurancecoverageinreducingunderfivemortalityinethiopiagompertzinversegaussiansharedfrailtymodelling AT zufanalamrieasmare protectiveroleofhealthinsurancecoverageinreducingunderfivemortalityinethiopiagompertzinversegaussiansharedfrailtymodelling AT hiwotaltayeasebe protectiveroleofhealthinsurancecoverageinreducingunderfivemortalityinethiopiagompertzinversegaussiansharedfrailtymodelling AT bizuneshfantahunkase protectiveroleofhealthinsurancecoverageinreducingunderfivemortalityinethiopiagompertzinversegaussiansharedfrailtymodelling AT abduhailushibeshi protectiveroleofhealthinsurancecoverageinreducingunderfivemortalityinethiopiagompertzinversegaussiansharedfrailtymodelling AT kebedegemedasabo protectiveroleofhealthinsurancecoverageinreducingunderfivemortalityinethiopiagompertzinversegaussiansharedfrailtymodelling |