Abstract
ObjectiveTo examine the levels, inequalities and factors associated with health insurance coverage in Kenya.MethodsWe analysed secondary data from the Kenya Demographic and Health Survey (KDHS) conducted in 2009 and 2014. We examined the level of health insurance coverage overall, and by type, using an asset index to categorise households into five socio‐economic quintiles with quintile 5 (Q5) being the richest and quintile 1 (Q1) being the poorest. The high–low ratio (Q5/Q1 ratio), concentration curve and concentration index (CIX) were employed to assess inequalities in health insurance coverage, and logistic regression to examine correlates of health insurance coverage.ResultsOverall health insurance coverage increased from 8.17% to 19.59% between 2009 and 2014. There was high inequality in overall health insurance coverage, even though this inequality decreased between 2009 (Q5/Q1 ratio of 31.21, CIX = 0.61, 95% CI 0.52–0.0.71) and 2014 (Q5/Q1 ratio 12.34, CIX = 0.49, 95% CI 0.45–0.52). Individuals that were older, employed in the formal sector; married, exposed to media; and male, belonged to a small household, had a chronic disease and belonged to rich households, had increased odds of health insurance coverage.ConclusionHealth insurance coverage in Kenya remains low and is characterised by significant inequality. In a context where over 80% of the population is in the informal sector, and close to 50% live below the national poverty line, achieving high and equitable coverage levels with contributory and voluntary health insurance mechanism is problematic. Kenya should consider a universal, tax‐funded mechanism that ensures revenues are equitably and efficiently collected, and everyone (including the poor and those in the informal sector) is covered.
Highlights
In 2005, WHO member states adopted a resolution to help member countries transform their health financing systems to achieve Universal Health Coverage (UHC) [1]
There was a considerable decrease in formal employment from 25.01% [95% CI 22.98–27.16] in the 2009 Kenya Demographic and Health Survey (KDHS) to only 11.19% [95% CI 10.40–12.03] in the 2014 KDHS
Health insurance coverage in Kenya increased from 8.17% [95% CI 6.76 - 9.83] to 19.59% [95% CI 18.40–20.83], between 2009 and 2014
Summary
In 2005, WHO member states adopted a resolution to help member countries transform their health financing systems to achieve Universal Health Coverage (UHC) [1]. UHC – defined as the provision of needed, and good quality health services to the entire population, without the risk of financial ruin [2, 3] – has received global support as recently enshrined in the Sustainable Development Goals (SDGs) 3.8 [4]. To achieve this goal, most lowand middle-income countries (LMIC) are increasingly prioritising UHC and reforming their health systems to achieve it. The NHIF provides health insurance cover to both individuals in the formal and informal sector.
Sign-in/Register to view highlights & summary 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.
