Effects of gender on uptake and willingness to join health insurance scheme in Uganda

Abstract

One way of achieving universal health coverage is through health insurance yet majority of Ugandans are not health insured. Uganda does not have a national health insurance scheme for universal health coverage. Health insurance currently stands at 3.9% in Uganda and out-of-pocket expenditure accounts for over 45% of total health expenditure. Considering that women tend to be poorer than men, they face a higher risk of catastrophic expenditures on health due to high incidence to disease. Therefore, it is against this background that the study examined the effects of gender on uptake and willingness to join health insurance in Uganda. The study employed a logit model on cross sectional secondary data from the Uganda National Household Survey 2019/20 conducted by the Uganda Bureau of Statistics. The study results revealed that respectively, women and men who own a bank account were 15.5 percent and 9.2 percent more likely to be willing to join a health insurance in Uganda. Similarly, women and men who own a bank account were 2.5 percent and 1.7 percent respectively more likely to utilize health insurance in Uganda. Furthermore, study findings showed that women who are literate were 16.8 percent more likely to be willing to join a health insurance while males who are literate were 7.3 percentage more likely to be willing to join a health insurance. Over more than half (54.9%) of men and about 45% of women were found to be willing to join a health insurance scheme. However, only a small proportion of the population (3.4%) are actually enrolled in any health insurance. A higher proportion of men compared to women were willing to join a health insurance – reflecting existing gender differences. Health insurance uptake was higher among men (60.8%) compared to women (39.1%). These findings depict gendered effects in willingness to join and utilization of health insurance. Being in a higher economic status proxied by having a bank account, and being literate significantly influence willingness to join and uptake of health insurance. Thus, improving the income earning of households and promoting education are important interventions for increasing utilization of health insurance. This implies that the poor and less educated are disadvantaged in accessing healthcare due to their limited use of health insurance, especially where out-of-pocket expenditures remain a dominant form of health care financing