Determinants of Health Seeking Behavior Among Households With Chronic Non-communicable Diseases in Kenya

Abstract

Chronic non-communicable diseases (CNCDs) contribute to over 70 % of total global mortality, with over 50% of Kenyans reported to suffer from more than one NCD. Over 55% of the Mortalities in Kenya are from CNCDs. There is limited knowledge on the socio-economic and demographic factors associated with health seeking behavior in kenya. The objective of this study was to assess the demographic and socio-economical determinants of health-seeking behavior among individuals with CNCDs in Kenya. The study adopted a cross-sectional study design using a secondary data from Kenya Household Expenditure and Utilization Survey (KHHEUS). The total data set had 31,622 households’ records, out of which 7,079 households were found to meet the study requirements in terms of having CNCD cases. Binary probit regression was used to determine the effect of demographic and socio-economic factors on the health-seeking behavior for CNCD households in Kenya. Majority (73%) of individuals with CNCDs sought care from a health facility. The mean and maximum age of the individuals with CNCDs was 41 and 96 years respectively. Out of 7,079 study participants, 61% were female and 46% married. Majority (71%) indicated that they had attained post primary education level. Majority (64%) had informal employment. Only 17% had a health insurance, with 22% of the respondents indicating to have a comorbid condition. Majority (66%) lived in a rural setting. Only 11% came from the wealthiest quintile while 23% came from the lowest wealth quintile. Females were found to seek more qualified care for CNCDs than males (β=-0.109, p-value=0.002,). Age squared, (β=0.011, p-value=0.011,), being married (β = 0.148, p-value=0.031,), secondary level education, Formal employment (β= 0.215, p-value=0.046,), having a health insurance (β = 0.222, ρ-value = 0.000, ), and higher wealth quintiles , Second lowest (β= 0.141, p-value=0.003,) middle (β= 0.233, p-value=0.000) second highest (β= 0.340, p-value=0.000,) highest (β= 0.215, p-value=0.000,), were all significantly associated with and increased ones’ chances of seeking qualified care for CNCDs. The study concludes that individuals owning insurance and being in higher income quintiles are main determinants influencing health seeking behaviour among individuals with CNCDs in Kenya. The study recommends that individuals with CNCDs be provided with subsidized health insurance schemes in order to increase their chances of health service utilization. In addition, the NHIF care package should be revised to comprehensively cover all CNCDs care and treatment.