Abstract
BackgroundThe Government of Kenya is making plans to implement a social health insurance program by transforming the National Hospital Insurance Fund (NHIF) into a universal health coverage program. The objective of this study was to examine the determinants associated with health insurance ownership among women in Kenya.MethodsData came from the 2008–09 Kenya Demographic and Health Survey, a nationally representative survey. The sample comprised 8,435 women aged 15–49 years. Descriptive statistics and multivariable logistic regression analysis were used to describe the characteristics of the sample and to identify factors associated with health insurance ownership.ResultsBeing employed in the formal sector, being married, exposure to the mass media, having secondary education or higher, residing in households in the middle or rich wealth index categories and residing in a female-headed household were associated with having health insurance. However, region of residence was associated with a lower likelihood of having insurance coverage. Women residing in Central (OR = 0.4; p < 0.01) and North Eastern (OR = 0.1; p < 0.5) provinces were less likely to be insured compared to their counterparts in Nairobi province.ConclusionsAs the Kenyan government transforms the NHIF into a universal health program, it is important to implement a program that will increase equity and access to health care services among the poor and vulnerable groups.
Highlights
The Government of Kenya is making plans to implement a social health insurance program by transforming the National Hospital Insurance Fund (NHIF) into a universal health coverage program
7% of the women had health insurance and among these, a higher proportion were covered by employerbased health insurance (4%), while less than 1% were covered by community-based health insurance schemes
A significantly higher proportion of women with health insurance were employed in the formal sector (17%) while 4% were employed in the informal sector and a similar proportion were unemployed (p < 0.001)
Summary
The Government of Kenya is making plans to implement a social health insurance program by transforming the National Hospital Insurance Fund (NHIF) into a universal health coverage program. Social health protection systems are mechanisms that countries use to address the challenges related to providing access to health care services to their citizens, especially the poor segments of the population. In Kenya, a universal social health insurance scheme has not been implemented; in November 2004, the government introduced the National Social Health Insurance Fund (NSHIF) Bill in parliament. As the government prepares to re-introduce the NSHIF legislation in parliament, it is important to have a better understanding of factors associated with participation in the current National Hospital Insurance Fund (NHIF), among the poor, as well as a determination of the proportion of individuals without access to health insurance among this demographic group. It is hoped that the proposed NSHIF will have mechanisms that will increase equity and access to health care services by all population groups
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