Socio-Economic Inequalities in Maternal and Reproductive Health Service Utilization Among National Health Insurance Scheme Policyholders in Zambia

Background: Among the numerous initiatives launched in Zambia to address healthcare challenges and inequalities, the National Health Insurance Scheme (NHIS) stands out as a significant development in the country's healthcare landscape. Methods: The study employed a quantitative research approach, using a descriptive cross-sectional design to assess the influence of Knowledge of the NHIS and socio-economic factors on the utilization of maternal and reproductive health services in Zambia. The study used a sample size of 385 NIHS policyholders. Data were collected using a well-structured self-administered questionnaire and analyzed using the statistical software STATA 14.0. Results: The results revealed a clear association between knowledge and utilization of Maternal and Reproductive Health services under the scheme, suggesting that participation in the scheme was primarily higher among individuals with a good understanding of the scheme (66%). A chi-square test showed a statistically significant association between education and willingness to contribute to the scheme (p-value = 0.005). Additionally, a correlation was found between the number of children participants had and their desire to contribute, yielding a p-value of 0.011. Similarly, the study found a significant association between marital status and willingness to contribute to the scheme (p-value = 0.407). these results suggest that participation in the utilization of the scheme increased with good knowledge, education, marital status and number of children. Conclusions: The study findings revealed a strong association between various socio-economic factors and their influence on willingness to participate in the scheme. The high level of awareness indicates the effectiveness of NHIMA's outreach initiatives.