Determinants of National Hospital Insurance Fund Uptake by Households in Kenya

Abstract

Out of pocket expenditure is a major source of health spending for households in Kenya with negligible payments coming from insurance placing them at peril of incurring medical expenditure exceeding 10% of the total household expenditure. National Health Insurance Fund (NHIF) is the main provider of health insurance coverage in Kenya, yet, only 26% of the Kenyan population is covered under NHIF. This study examined the socio- economic determinants related to uptake of NHIF by households in Kenya. The independent variables were education, religion, household size, marital status, chronic illness, access to information, employment and wealth status (quintile). The dependent variable was uptake of NHIF. Social exchange theory and Expected Utility Theory informed the study. The study used Probit model which is appropriate when analyzing dichotomous responses. Data for the study was mined from the 2018 survey by Ministry of Health on Kenya Household Health Expenditure. Findings from the study verify that socio-demographic factors contribute significantly to uptake of NHIF insurance among households. Among these are wealth status, marital status, employment status and level of education. The study recommends for inclusion of basic health insurance concepts in school curricula. The government should come up with viable means for subsidizing health insurance for households to stir uptake and continuation as well as creating an enabling business environment to enhance households wealth status which will translate to increased enrollment to NHIF