ArticleBMC health services research2022
Mandatory health insurance and health care utilization in Togo.
Article in BMC health services research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
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Who cites it
4 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Epidemiology of clinical antimicrobial-resistant Enterobacterales in Togo over three decades: a systematic review and meta-analysis, with recommendations and alternative solutions.BMC infectious diseases · 2025Pooled it
- Population-attributable fractions for risk factors for childhood anaemia: findings from the 2017 Togo Malaria Indicator Survey.The British journal of nutrition · 2025Article
- Prevalence of presumptive clinical signs of breast cancer among women attending an early detection campaign in Lomé in 2023.The Pan African medical journal · 2025Article
- The path to universal health coverage in five African and Asian countries: examining the association between insurance status and health-care use.The Lancet. Global health · 2024Review
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2 authors.
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Abstract
backgroundDespite the implementation of a mandatory health insurance (MHI) scheme in Togo since 2011, its coverage rate remains low, resulting in a high out-of-pocket payment rate. More than 10 years after its implementation, there are few empirical studies investigating the extent to which Togo's mandatory health insurance has improved beneficiaries' access to health care. Examining how MHI and healthcare use in Togo are related is the goal of this study.
methodsWe use data from the Harmonized Survey on Living Conditions of Households (EHCVM), conducted in the member states of the West African Economic and Monetary Union (WAEMU) in 2018-2019 and covering 6,171 households in Togo. We employ multinomial logistic regression, given that the dependent variable is polytomous.
resultsThe results reveal a high rate of non-utilization of healthcare professionals in the case of illness, even among individuals with MHI coverage. Furthermore, the findings show that the MHI increases the likelihood of seeing a specialist physician and other formal health care professionals when sick. The results also reveal that a household's wealth is positively correlated with the likelihood of seeing formal health care professionals. Urban residents are statistically and significantly more likely than rural residents to see both a specialist physician and a general practitioner. The Grand Lomé region has a statistically and significantly higher likelihood of seeing a specialist physician than the Maritime region.
conclusionThe results support the government's plan to implement universal health insurance. The government should take action to raise the standard of treatment provided to insured patients in health care centers. Additionally, the government should consider waiving medical fees for low-income policyholders. When waiving medical costs for low-income policyholders, the Togolese government should focus on the regions with the worst economic conditions. These interventions should be essential to ensure that no one is left behind. The difference between urban and rural communities should be reduced through supply-side policies that focus on rural areas.
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