The effect of community-based health insurance schemes on utilization of healthcare services in low- and middle-income countries: a systematic review protocol of quantitative evidence

The effect of health insurance coverage on antenatal care utilization in Cambodia: A secondary analysis of Cambodia Demographic and Health Survey 2021-2022

Health insurance is essential in reducing or eliminating the financial constraint to accessing maternal health services caused by out-of-pocket payments. Also, it has a beneficial effect in minimizing maternal and child mortality. However, limited studies in Cambodia examined the association between health insurance coverage on antenatal care (ANC) utilization. Therefore, this study has examined the effect of health insurance coverage on ANC utilization in Cambodia. We utilized data from the 2021-2022 Cambodia Demographic and Health Surveys (CDHS), analyzing a total sample of 3,162 weighted women who gave birth within two years. Multiple logistic regression model using STATA V17 to assess the association between health insurance coverage with women who attended four or more ANC visits. About 24.9% of the women had health insurance coverage during 2021-2022. Most (86.1%) of women attended four or more ANC visits. Women with health insurance coverage were statistically significantly associated with attending four or more ANC visits with an adjusted odds ratio (AOR = 1.6; 95% CI: 1.1-2.4). Other factors significantly associated with attending four or more ANC visits include women with higher education (AOR = 3.1; 95% CI: 1.2-7.7), secondary education (AOR = 2.3; 95% CI: 1.5-3.5), richest households (AOR = 3.2; 95% CI: 1.5-6.8), and richer households (AOR = 1.9; 95% CI: 1.2-2.8). Pregnant women with health insurance coverage who had completed at least secondary education and had a better wealth index were more likely to attend at least four ANC visits. Thus, providing health insurance coverage and improving women's economic and educational may be essential to improving women's access to maternal health services in Cambodia.

Factors influencing the readiness to tackle the burden of ischaemic heart disease in India: a systematic review protocol

INTRODUCTION

Ischaemic heart disease (IHD) is one of the leading causes of death and disease burden in India affecting all age groups. To reduce the deaths and tackle the burden of existing IHD, the government approach has been mostly through the National Health Policy (2017) and National Programme for Prevention and Control of Diabetes, Cardiovascular diseases and Stroke. This paper offers a protocol for the systematic review of studies exploring the factors influencing service readiness of the public health system of India to tackle the burden of IHD.

METHODS AND ANALYSIS

Electronic databases of Embase (Ovid), AMED (Ovid), HMIC (Ovid), BNI (ProQuest), CINAHL (EBSCO), EMCARE (Ovid), PsycINFO (ProQuest), MEDLINE/PubMed and Web of Science (Clarivate Analytics) will be searched till 2020 for primary studies. Grey literature will be accessed through OpenGrey, TRIP Medical, WHO database, MoHFW website, Open Government Data (OGD) Platform of India and Google Scholar (between 2010 and 2020). Primary studies meeting the eligibility criteria and grey literature published in English between 2010 and 2020 will be included. Data will be analysed through a conceptual framework, and the primary outcome will constitute both quantitative and qualitative data. The quality of included studies will be assessed based on study design. Data will be managed on the COVIDENCE platform. All authors will be involved in data extraction, quality appraisal, data synthesis and formulation of the final draft.

ETHICS AND DISSEMINATION

This study, being a systematic review, does not involve any clinical trial, primary data collection or empirical study involving humans or animals. Therefore, no ethical permissions were sought by reviewers.

PROSPERO REGISTRATION NUMBER

CRD42020219490.