Ecological zone and health insurance coverage among adolescent girls in Ghana: analysis of the 2017 maternal health survey

Aim: Health insurance has been recognized globally as one of the significant means of financing healthcare to achieve universal coverage, particularly in low and middle-income countries. This article sought to examine how ecological zone interacts with other socio-demographic characteristics to influence health insurance coverage among adolescent girls in Ghana. Subjects and methods: The study used data from the 2017 Ghana Maternal Health Survey. A sample size of 3767 adolescent girls was used for this study. This study employed both descriptive and inferential analytical approaches to analyze the data using STATA version 14.0. Results: The study found that ecological zone has a statistically significant association with health insurance coverage among adolescent girls in Ghana, with adolescent girls in the Northern Zone less likely to be covered by health insurance than those in the Coastal Zone [AOR = 0.76, CI = 0.58–0.98]. Other factors that determined health insurance coverage among adolescent girls in Ghana were age, parity, education level and marital status. Conclusion: With adolescent girls in the Northern Zone less likely to be covered by health insurance, it is unlikely that Ghana will be able to achieve equity in healthcare even with the existence of health insurance. If this situation persists, the ability of the country to work towards achieving Sustainable Development Goal 3, which seeks to ensure healthy lives and promote well-being for all at all ages, is under threat