Abstract
BackgroundAccess to affordable and effective health care is a challenge in low- and middle- income countries. Out-of-pocket expenditure for health care is a major cause of impoverishment. One way to facilitate access and overcome catastrophic expenditure is through a health insurance mechanism, whereby risks are shared and financial inputs pooled by way of contributions. This study examined factors that influenced the enrolment status of dairy farmers in Western Kenya to a community health insurance (CHI) scheme.MethodsQuantitative, cross-sectional research was used to describe factors influencing the enrolment in the CHI scheme. Quota and convenience sampling was used, recruiting a sample of 135 farmers who supply milk to a dairy cooperation. Data were collected using a structured interview schedule and analysed using Stata SE, Data Analysis and Statistical Software, Version 12.ResultsFactors influencing non-enrolment were identified as affordability (40%; n = 47), unfamiliarity with the management of the scheme (37%; n = 44) and a lack of understanding about the scheme (41%; n = 48). An exploratory factor analysis was used to reduce the variables to two factors: information provision and understanding community health insurance (CHI). Logistic regression identified factors associated with enrolment in the Tanykina Community Healthcare Plan (TCHP). Supplies of less than six litres of milk per day (OR: 0.22; 95% CI: 0.06–0.84) and information provision (OR: 8.77; 95% CI: 2.25–34.16) were significantly associated with enrolment in the TCHP.Nearly 30% (29.6%; n = 40) of the respondents remarked that TCHP is expensive and 17% (n = 23) asked for more education on CHI and TCHP in an open-ended question.ConclusionRecommendations related to marketing strategies, financial approach, information provision and further research were outlined to be made to the management of the TCHP as well as to those involved in public health.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1925-1) contains supplementary material, which is available to authorized users.
Highlights
Access to affordable and effective health care is a challenge in low- and middle- income countries
The results indicate that the average age of those enrolled tended to be higher than that of those who were not enrolled
To make Tanykina Community Healthcare Plan (TCHP) financially viable, it is recommended that workable solutions for social inclusion of the poorest and those with low income should be identified and that cost-effective ways be created in which farmers who are not able to supply milk consistently might be able to bridge the gap of the “dry” months in milk production
Summary
Access to affordable and effective health care is a challenge in low- and middle- income countries. One way to facilitate access and overcome catastrophic expenditure is through a health insurance mechanism, whereby risks are shared and financial inputs pooled by way of contributions. Despite the evidence on the potential of CHI to improve access to quality health care, enrolment in sub-Saharan Africa remains low [4]. There is strong evidence that CHI improves the mobilisation of resources for health and the utilisation of health services [5]. It provides financial protection for members in terms of reducing their out-of-pocket expenditure [5]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
