Exploring health insurance as a financial buffer in Maternal and Child Health in the Democratic Republic of Congo

• Health insurance coverage among pregnant women and new mothers in the DRC remains critically low at 3%. • Financial constraints, limited health insurance literacy, and information frictions suppress demand for insurance. • Households without coverage rely on informal copying strategies and reduce investment in children’s education. • Improved health and insurance literacy is associated with greater uptake and better health outcomes. • Expanding public health insurance schemes may enhance financial protection and promote human capital accumulation. This study investigates the low health insurance coverage among pregnant women and new mothers in selected health zones of DRC, aiming to identify underlying factors and associated implications. The results from the sociodemographic analysis show that only 3% of our respondents reported having insurance coverage. This low coverage is primarily attributed to financial constraints, lack of information, and perceived low value relative to premium costs. The study revealed significant barriers to health insurance uptake, including inadequate health and insurance literacy. Without insurance, households often resort to coping strategies such as family support, informal borrowing, and reduced investment in children’s education. The study also highlights that enhanced health insurance literacy is positively associated with health insurance adoption and better health outcomes. Addressing low health insurance coverage requires targeted interventions to improve financial access and health literacy, and disseminate transparent information about insurance benefits. Implementing health insurance schemes could alleviate financial burdens, minimize reliance on informal networks, and improve health outcomes. Enhanced health insurance coverage, through effective communication and education, could substantially benefit socioeconomic conditions, particularly for mothers and children in the DRC.