Effect of transitioning from a pilot universal health coverage program on workload in select government-owned hospitals in Nyeri, Kenya

Abstract

ABSTRACT Background Universal health coverage (UHC) aims to provide individuals with healthcare without predisposing them to catastrophic health expenditures. In 2019, the Kenyan government piloted UHC in Nyeri county followed by mass rollout of UHC nationally. This study assessed the effect of this transition on the workload of hospitals in Nyeri. Methods The workload of two major government-owned hospitals were compared to that of similar faith-based hospitals in Nyeri County. This was for one year pre-pilot UHC, one year during the pilot and one year post pilot. A difference-in - differences analysis was done. Results During the pilot UHC, the county referral hospital recorded an increase in eight workload indicators, with four increasing significantly. During the post- pilot period, eight workload indicators declined significantly. During the pilot UHC, Karatina level-4 hospital recorded an increase in seven workload indicators, with three increasing significantly. One indicator declined, though insignificantly. During the post-UHC period, four workload indicators declined, with two significantly. Another two indicators increased significantly. Conclusion Transitioning from the pilot UHC program resulted in a decrease in workload. A plausible reason could be some segment of the population previously covered under the pilot UHC were left exposed post-pilot UHC.