CEOR_A_322087 693..701

1Department of Epidemiology and Biostatistics, College of Health and Medical Sciences, Haramaya University, Haramaya, Ethiopia; 2Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 3Department of Public Health and Health Policy, College of Health and Medical Sciences, School of Public Health, Haramaya University, Harar, Ethiopia Background: Despite improvement in access to modern healthcare services in East African countries, health-service delivery and health status of the population remained poor mainly due to the weak health-sector financing system. Therefore, the current study aimed to assess the health insurance coverage and its associated factors among reproductive-age group (RAG) women in East Africa. Methods: The most recent (between 2010 and 2018) Demographic and Health Surveys (DHS) data of the ten East African countries (Burundi, Comoros, Ethiopia, Kenya, Malawi, Mozambique, Tanzania, Uganda, Zambia, and Zimbabwe) were included. STATA version 16.0 statistical software was used for data processing and analysis. In the multilevel mixedeffects generalized linear model, variables with a p-value ≤0.05 were declared as significant associated factors of health insurance coverage. Results: The overall health insurance coverage in East Africa was 7.56% (95% CI: 7.42%, 7.77%). The odds of health insurance coverage were high among educated, currently working, and rich RAG women whereas it was low among rural residents. Besides, RAG women who have media exposure, visited by field workers, and visited health facilities have a higher chance of health insurance coverage. Conclusion: Health insurance coverage in East Africa among RAG women was below ten percent. Educational status, working status, place of residence, wealth index, media exposure, visiting health facility within 12 months and being visited by field worker were significantly associated with health insurance coverage among RAG women in East Africa. Improving women’s access to health facilities, promoting field workers’ visit, and media exposure targeting uneducated, unemployed, and rural resident women of RAG will be a gateway to promote health insurance coverage.