Socio–economic Determinants of National Health Insurance Fund Membership in the Informal Sector:a Case Study of Kitui West Sub-county, Kenya
Abstract
Most nations have failed to provide their citizens with accessible and high-quality health
care. National and international treaties have been ratified with little if any success as a
result of this. In Kenya, against the expectations of successive governments –KANU,
NARC, Grand coalition and Jubilee - the implementation of health insurance program for
the mostly poor and vulnerable populations has been challenging. Registration into the
state health insurer of this population of Kenyans has been discouraging and low. This
study has been motivated by the desire to establish why NHIF since opening, its doors to
informal sector workers 50 years ago has not been able to make significant impact in
bringing these workers on board. The objective of the study was to establish the influence
of socio-economic factors on NHIF membership in the informal sector. The study
narrowed on four variables i.e income level, education level, age and gender. A cross
sectional study was implemented to systematically sample primary data. Structured
questionnaire for the self-employed population in Kitui west sub-county were utilised.
Stratified sampling was used to collect data from 100 respondents. The four wards of the
sub-county were used to build strata, each ward was viewed as a stratum. The data
collected was analysed using SPSS to transform it from raw to usable information with
the primary goal of establishing facts and imparting knowledge.
The study established that health insurance coverage varies significantly across income
groups. It was found that a respondent‟s level of education was significant in influencing
their decision to enrol. Age is a significant determinant of NHIF registration. However,
this is confounded by other variables such as education and income which are likely to
increase with age. Gender plays a role in determining NHIF membership. As is the case
with age variable, this is confounded by other variables namely; Income and education.
This is because men are more likely to be more educated and also have a higher income
compared to women. Women are also disadvantaged by power hierarchy within the
households as enrolment decisions are made by the husbands as the head of households.
Overall, the study revealed that income level and education level are the major
determinants of enrolling into a health insurance scheme.
Publisher
University of Nairobi
Rights
Attribution-NonCommercial-NoDerivs 3.0 United StatesUsage Rights
http://creativecommons.org/licenses/by-nc-nd/3.0/us/Collections
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