PHD-Department of Economic Theory

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Browsing PHD-Department of Economic Theory by Author "Kimalu, Paul Kieti"

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    Household health expenditure and health outcomes in Kenya
    (2013-10-15) Kimalu, Paul Kieti
    This study's aim was to examine household health expenditure, health financing inequities and health outcomes in Kenya. To analyze the determinants of household health expenditure in Kenya, the study used a twopart model. To analyze the determinants of catastrophic health expenditure, this study used bivariate probit with sample selection. The extent of household financing inequities was analyzed using Kakwani and concentration indices. To analyze the determinants of health outcomes in Kenya, the study constructed a pseudo-panel data model, which was estimated using Generalized Methods of . Moments. This study used household data from Welfare Monitoring Surveys (WMS) and the Kenya Integrated Household Budgetary Survey data sets. The Welfare Monitoring Surveys were conducted in 1992, 1994 and in 1997. The Kenya Integrated Household Budget Survey was carried out in 200512006. Data on county population, number of health facilities, literacy rates and public health budget allocation were obtained from various Government sources. The findings on the determinants of household health expenditure established that higher household income was associated with higher household health expenditure, while higher public health budget allocation to the counties was associated with lower household health expenditure. Visiting public health providers was associated "Yith lower household health expenditure compared to private and mission health. providers. On the determinants of catastrophic health expenditure, the study findings indicated that household members . visiting private and mission health providers were more likely to incur catastrophic health expenditure compared to those visiting public health providers. Households with lower probability of incurring catastrophic health expenditure were those in rich income quintiles, in urban areas, and with household heads having at least primary education. The study findings show evidence of inequities in health financing. The study findings show household health expenditure concentration index of 0.45,0.53 and 0.75 in 1992, 1994 and 1997, respectively, indicating that the rich households were contributing more than the poor households in financing health care. With regard to key determinants of household health outcomes, the study found that higher household income, larger proportion of households with safe water source, literacy rate and progressivity in household health care financing measured through Kakwani indices were associated with improved health outcomes. However, larger household size worsened health outcomes. The study recommends that the Government considers increasing health budget allocation. The study also recommends that the Government considers strengthening and enforcing her policy of provision, accessibility and affordability of health care services by further investing in public health facilities and improving their distribution. Finally, the Government could consider designing and developing health financing mechanisms to protect the poor and the vulnerable from catastrophic health expenditure