Does health insurance coverage improve maternal healthcare services utilization in India? Evidence from National Family Health Survey-5, 2019-21

ObjectiveUniversal health coverage and maternal health outcomes have become a part of the global health agenda in low and middle-income countries including India. To achieve the sustainable development goals (SDG-3), maternal healthcare services utilization is a significant intervention in decreasing maternal mortality and morbidity. This study aims to assess the potential association between health insurance coverage (HIC) and maternal healthcare services utilization in India.MethodsData was obtained from the fifth round of the National Family Health Survey (NFHS-5), conducted during 2019-21. Bivariate, spatial analysis and logistic regression models have been used to assess association between utilization of maternal healthcare services and HIC combined with other background factors in India.ResultsHIC among women was found to be 24%. Approximately 59%, 90% and 46% of women had full antenatal care (ANC) visits, skilled birth attendant (SBA) and post-natal care (PNC), respectively. The study results suggested that individuals with HIC were more likely to have ANC visits (OR = 1.28; 95% CI 1.25-1.31), SBA (OR = 1.41; 95% CI 1.36-1.46) and PNC (OR = 1.16; 95% CI 1.13-1.18) services, respectively. Moreover, socioeconomic characteristics and other predictor variables were significantly associated with maternal healthcare service utilization in India.ConclusionThe study concludes that HIC is a significant predictor for the maternal and child healthcare services in India, and women with HIC were more likely to have full ANC visits, SBA and PNC. Overall, to accelerate the progress towards achieving SDGs related to maternal and child health, the government should expand and strengthen the existing policies to increase coverage of health insurance.