Demographic factors influencing the uptake cf community based health financing schemes in Mathare valley, Nairobi county, Kenya

Abstract

Following the shift in policy as a reaction to Structural Adjustment Programs (SAPs) in the l990s, the government of Kenya introduced user fee in hospitals which was later seen as undesirable as it led to low facility utilization, discrimination against the poor hence resulting to advocacy for its removal. User fees and other out of pocket (OOP) payments have impacted negatively on utilization of health care services in Kenya and the majority of the population cannot afford to pay for health care. Those who pay for care incur high costs that are sometimes catastrophic and adopt coping strategies with negative implications for their socio-economic status, while other simply fails to seek care. Inability to pay the OOP payment expenditure required to access health services is one of the main impediments to access healthcare particularly for the poor and the vulnerable. As a result to this, there emerged increase in Community Based Health Financing (CBHF) schemes initiative as an alternative to health financing. However, the enrollment has ever remained low among the target group. The researcher in this study endeavors to assess the influence of demographic factors on the uptake of community based health financing schemes in the Country. These CBHF schemes in Kenya are registered under the Ministry of Gender and Youth. The objectives of this study are to establish how biological factors, level of education, socio cultural factors and the level of income influences the uptake of CBHF in Mathare valley, Nairobi County. The study reviews relevant literature by various researchers and institutions on biological factors, level of education, socio cultural and level of income and their influence of the uptake of the CBHF. A sample of 372 individuals was randomly selected using a stratified sampling. Questionnaires with both closed and open ended questions were used to collect data from the respondents. Observation and interview methods were also be applied in the process. The study also used both primary and secondary data available for the purposes of acquiring information and for triangulation. In analyzing the data it was refined and cleaned to eliminate any unwanted information, then coded and classified into categories. Findings were then presented in tables and figures and then interpreted. The study revealed that age and gender, education and income level did really to a great extent influence the uptake of CBHF unlike socio cultural factors that influence the uptake to very small extent. The study recommends that there is need for a policy to make the CBHI increase the uptake in order to take advantage of economic of scale, to provide the people with an accessible, affordable, and reliable health insurance.