Birth plans and health insurance enrolment of pregnant women: a cross-sectional survey at two secondary health facilities in Lagos, Nigeria

Abstract

Objective: We evaluated birth plans and health insurance enrolment of pregnant women at secondary health care level as a strategy for post-2015 goals.

Methods: This was a cross-sectional study at two secondary health facilities in Lagos state, Nigeria. A pre-tested questionnaire was used to collect data that were analysed and results presented with frequencies. An overall estimate with 95% confidence interval was used at significant p values of less than 0.05.

Results: Five hundred and twenty-four women, with a mean age of 3 0±4.1 years, participated. Most women chose hospital delivery (84%) and had plan for transportation (86.3%) during labour. Few women were well prepared for birth (9.7%) and had health insurance (10.1%). Compared with women without insurance, more health-insured women had plans for transport in labour (p = 0.1383) and identified a place of birth (p = 0.2294), but did not have as much plan for someone to accompany them in the case of an emergency (p = 0.3855) and donate blood (p = 0.5065). Few health insured women saved money for delivery (p = 0.7439).

Conclusion: Health insured women did not have better birth plans and expanding pregnant women’s access to health insurance may be an insufficient strategy to achieve post MDG 2015 goals.

• Maternal mortality
• near-miss
• severe maternal outcome