Determinants of Uptake of National Hospital Insurance Fund Scheme by the Informal Sector in Nairobi County, Kenya

Abstract

t’s important to address disparities in access to health insurance among those in the informal sector of whom majority are poor and of marginalised groups in order to accelerate the achievement of Millennium Development Goals (MDGs) and also to identify interventions that will mitigate this situation. The purpose of the study was to determine the determinants of uptake of National Hospital Insurance Fund scheme by the informal sector in Kenya, which will be of significance to the government of Kenya in formulating and implementing health insurance policy and in the current process of transforming into a universal health scheme. The target population was the informal sector participants at Laini Saba market, Kibera division, Nairobi County with a population of approximately 350 traders. Descriptive study design was adopted while stratified random sampling method was also applied to select the respondents according to the different enterprises they operate in and the sample size was 97 respondents. The data collection tools were questionnaires with both closed and open ended questions which were reviewed, cleaned and coded to minimize errors and enable easy entry and analysis. Statistical Package for Social Sciences (SPSS) version 20 was used to organise the data and carry out statistical analysis. At univariate level, descriptive analysis using frequencies and percentages was carried out while at bivariate level, multinomial logistic regression was carried out to determine the association between the dependent and independent variables at 0.05 level of significance. In the findings only 32% of respondents were enrolled in NHIF scheme, while 7.1% were enrolled in another type of health scheme. The logistic regression model found that NHIF uptake was significantly associated with income level (P=0.049 95% CI -1.172- -0.003), awareness of NHIF benefits (P=0.013 95% CI -6.366 - -0.744) and access to NHIF outlets (P=0.011 95% CI - 6.470- -0.852), since their p-values were < 0.05 indicating that all the variables were statisticallysignificant.