Factors influencing uptake of national hospital insurance fund cover by rural households in Kasipul division, Rachuonyo south sub county, Homa Bay county

Abstract

The purpose of the present study was to determine Factors Influencing Uptake of National Hospital Insurance Fund (NHIF) by Rural Households in Kasipul Division, Rachuonyo SubCounty, Homa Bay County in Homa Bay County. The study was guided by the objectives: to determine the extent to which the demographic characteristics influence uptake of NHIF Cover by rural households in Kasipul Division, Rachuonyo Sub-County, Homa Bay County; to establish the extent to which socio-economic factors influence NHIF uptake among rural households in Kasipul Division, Rachuonyo Sub-County, Homa Bay County; to investigate the extent to which awareness influence NHIF uptake among rural households in Kasipul Division, Rachuonyo SubCounty, Homa Bay County; and to establish the extent to which institutional factors influence NHIF uptake in rural households in Kasipul Division, Rachuonyo Sub-County, Homa Bay County. The study findings was of significance to the Government of Kenya in formulating and implementing health insurance policy targeting rural households and in their current process of transforming NHIF into a universal health scheme for every Kenyan. The target population for this study was rural households drawn from Rachuonyo South District's Kasipul Division in Homa Bay County. Descriptive study design is adopted while stratified random sampling method was applied to select the respondents according to the different administrative locations they come from within Kasipul Division. In this study, the sample size was drawn using the Morgan Table basing the size of the actual population as per 2009 national population census report. The data collection tools for this study included questionnaires with both closed and open ended questions which shall be reviewed, cleaned and coded to minimize errors and enable easy entry and analysis. Statistical Package for Social Sciences (SPSS) version 20 aided by a computer was used to organize 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 5% level of significance. Besides, the study was valid and reliable in taking the desired measures to ensure data validity and reliability. The study was based on the basic assumptions that the data collection instruments was realistic and reliable in taking the desired reactions. In addition, the study was also assume that the respondents was willing to give information honestly and distinctively. The survey data revealed that 75% of the respondents or 315 households out of 420 households indicated not having NHIF Insurance Cover against a total of 105 households or 25% of the households who said they had NHIF Cover. In further interrogation of the respondents, the researcher established that those who are not covered by NHIF were mainly those aged between 18 and 35 and are in the informal sector, especially “Jua Kali” and “Boda Boda Riders”. Others who were not already covered were the small-scale traders, especially “mama mbogas” who argued that they are not in a position to meet the monthly NHIF subscription, especially now that the amount is increased. On the other hand, interaction, the frequency of interacting with NHIF staff was indicated to be very often and influenced uptake of NHIF significantly. The most effective and common product marketing and sales strategy was found out to be through local hospitals Finally, financial affordability was seen as being a major issue with NHIF with a majority of respondents saying that their inability to meet monthly NHIF subscriptions had incapacitated their ability to take up NHIF cover.