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Determinants for participation in a public health insurance program among residents of urban slums in Nairobi, Kenya: results from a cross-sectional survey

BMC health services research, 2012-03, Vol.12 (1), p.66-66, Article 66 [Peer Reviewed Journal]

COPYRIGHT 2012 BioMed Central Ltd. ;2012 Kimani et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. ;Copyright ©2012 Kimani et al; licensee BioMed Central Ltd. 2012 Kimani et al; licensee BioMed Central Ltd. ;ISSN: 1472-6963 ;EISSN: 1472-6963 ;DOI: 10.1186/1472-6963-12-66 ;PMID: 22424445

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Title:
Determinants for participation in a public health insurance program among residents of urban slums in Nairobi, Kenya: results from a cross-sectional survey
Author: Kimani, James K ; Ettarh, Remare ; Kyobutungi, Catherine ; Mberu, Blessing ; Muindi, Kanyiva
Subjects: Adult ; Age Distribution ; Community Participation - economics ; Cooperatives ; Cost control ; Cross-Sectional Studies ; Employment ; Female ; Health care access ; Health care expenditures ; Health insurance ; Humans ; Informal economy ; Insurance coverage ; Insurance premiums ; Kenya ; Logistic Models ; Male ; Marital Status ; Medically Uninsured - statistics & numerical data ; Microfinance institutions ; Middle Aged ; National health insurance ; National Hospital Insurance Fund ; Poverty Areas ; Public Health - economics ; Public health insurance ; Public participation ; Sex Distribution ; State Medicine - economics ; State Medicine - legislation & jurisprudence ; Studies ; Urban Health - economics ; Urban Health - statistics & numerical data ; Urban slums ; Young Adult
Is Part Of: BMC health services research, 2012-03, Vol.12 (1), p.66-66, Article 66
Description: 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. This paper examines the determinants associated with participation in the NHIF among residents of urban slums in Nairobi city. The study used data from the Nairobi Urban Health and Demographic Surveillance System in two slums in Nairobi city, where a total of about 60,000 individuals living in approximately 23,000 households are under surveillance. Descriptive statistics and multivariate logistic regression analysis were used to describe the characteristics of the sample and to identify factors associated with participation in the NHIF program. Only 10% of the respondents were participating in the NHIF program, while less than 1% (0.8%) had private insurance coverage. The majority of the respondents (89%) did not have any type of insurance coverage. Females were more likely to participate in the NHIF program (OR = 2.4; p < 0.001), while respondents who were formerly in a union (OR = 0.5; p < 0.05) and who were never in a union (OR = 0.6; p < 0.05) were less likely to have public insurance coverage. Respondents working in the formal employment sector (OR = 4.1; p < 0.001) were more likely to be enrolled in the NHIF program compared to those in the informal sector. Membership in microfinance institutions such as savings and credit cooperative organizations (SACCOs) and community-based savings and credit groups were important determinants of access to health insurance. The proportion of slum residents without any type of insurance is high, which underscores the need for a social health insurance program to ensure equitable access to health care among the poor and vulnerable segments of the population. As the Kenyan government moves toward transforming the NHIF into a universal health program, it is important to harness the unique opportunities offered by both the formal and informal microfinance institutions in improving health care capacity by considering them as viable financing options within a comprehensive national health financing policy framework.
Publisher: England: BioMed Central Ltd
Language: English
Identifier: ISSN: 1472-6963
EISSN: 1472-6963
DOI: 10.1186/1472-6963-12-66
PMID: 22424445
Source: Open Access: PubMed Central
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Geneva Foundation Free Medical Journals at publisher websites
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Determinants for participation in a public health insurance program among residents of urban slums in Nairobi, Kenya: results from a cross-sectional survey

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