Health insurance for the poor decreases access to HIV testing in antenatal care: evidence of an unintended effect of health insurance reform in Colombia

by Allison Ettenger, Till Bärnighausen and Arachu Castro
Health Policy Plan. (2013) – First published online: April 18, 2013

7 pp. 138 kB:
http://heapol.oxfordjournals.org/content/early/2013/04/18/heapol.czt021.full.pdf+html

Prevention of mother-to-child transmission of HIV was added to standard antenatal care (ANC) in 2000 for Colombians enrolled in the two national health insurance schemes, the ‘subsidized regime’ (covering poor citizens) and the ‘contributory regime’ (covering salaried citizens with incomes above the poverty threshold). Overall, health-care providers ordered an HIV test for only 35% of the women attending ANC. Women enrolled in the subsidized regime were significantly less likely to be offered and receive an HIV test in ANC than women without any health insurance. Additional research is needed to elucidate the mechanisms through which the potential effect of health insurance coverage on HIV testing in ANC occurs and to examine whether enrolment in the subsidized regime has affected access to other essential health services.

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