Abstract
IntroductionIn Kenya, maternal and child health accounts for a large proportion of the expenditures made towards healthcare. It is estimated that one in every five Kenyans has some form of health insurance. Availability of health insurance may protect families from catastrophic spending on health. The study intended to determine the factors affecting the uptake of health insurance among pregnant women in a rural Kenyan district.MethodsThis was cross-sectional study that sampled 139 pregnant women attending the antenatal clinic at a level 5 hospital in a Kenyan district. The information was collected through a pretested interview schedule.ResultsThe median age of the study participants was 28 years. Out of the 139 respondents, 86(62%) planned to pay for their deliveries through insurance. There was a significant relationship between insurance uptake and marital status Adjusted odds ratio (AOR) 6.4(1.4-28.8). Those with tertiary education were more likely to take up insurance AOR 5.1 (1.3-19.2). Knowing the benefits of insurance and the limits the insurance would settle in claims was associated with an increase in the uptake of insurance AOR 7.6(2.3-25.1), AOR 6.4(1.5-28.3) respectively. Monthly income and number of children did not affect insurance uptake.ResultsBeing married, tertiary education and having some knowledge on how insurance premiums are paid are associated with uptake of medical insurance. Information generated from this study if utilized will bring a better understanding as to why insurance coverage may be low and may provide a basis for policy changes among the insurance companies to increase the uptake.
Highlights
In Kenya, maternal and child health accounts for a large proportion of the expenditures made towards healthcare
Majority (75%) were married and 37% of the study participants were in their first pregnancy. 86(62 %) of the women recruited in the study indicated that they would be paying for their deliveries or hospitalizations using medical insurance
National Hospital Insurance Fund (NHIF) was the preferred choice in all the cases. 23(17%) of the women would pay out of pocket and another 17% would request for assistance from relatives
Summary
In Kenya, maternal and child health accounts for a large proportion of the expenditures made towards healthcare. Women of child bearing age (18- 45 years) are excluded from insurance and this affects more so those in the rural areas [6] Those in formal employment are more likely to have some form of medical insurance unlike those in the informal sector and those who are unemployed [11, 12]. These counties are responsible for the management of level one to level five facilities and the central government manages the level six facilities With this basic understanding of the current health service and financing system, we sought to understand the perceptions and practices of women of in child bearing age in rural areas health towards insurance. This study aimed to determine the factors that affect the uptake of the health insurance among pregnant women attending an antenatal clinic (ANC) in a level five facility in rural Kenya. Our choice of a level five facility was based on the fact that there are specialized obstetric services offered at this level more women were likely to visit and the fact that level five facilities cover a large catchment a wide
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