Factors influencing the uptake of health insurance schemes among Kibera Informal Settlement Dwellers, Nairobi, Kenya

Abstract

Background. For a country to achieve its development goals, it has to devise appropriate mechanisms that can ensure that her people are healthy enough to steer their own economic development. Kenya is a developing country and therefore, health insurance schemes are seen as a sustainable way to ensure health lives and promote well-being for all at all ages in order to attain high social economic development. This paper basically examines factors influencing the uptake of health insurance schemes among Kibera informal settlement dwellers in the capital city of Kenya.

Objective: To determine factors influencing the uptake of health insurance schemes among Kibera informal settlement dwellers, Nairobi County.

Design: Descriptive cross section study.

Setting: Kibera slum in Nairobi County.

Subjects: House holds Heads.

Results: The proportion of respondents who had taken up health insurance in the informal settlement were 27.1% (n=45). Significant relationships (p<0.005) between health insurance enrollment and measured factors (measured as odds ratios (ORs)) were obtained as follows: compared to married respondents (OR=I), single, separated/divorced and widowed respondents were 68%,86%, 62% respectively less likely to own the insurance. Respondents who had attained post-secondary, secondary and primary education were 11.3, 2.3 and 1.6 times more likely to take up insurance compared to those with no formal education. Respondents working in the informal employment sector were 96% less likely to be enrolled in the health insurance program compared to those in the formal sector. Non –members in a local informal social welfare group were 78% less likely to take up insurance compared to members who were in the welfare. Respondents who earned greater than Kes 10,000 and between Kes 5,001 and Kes 10,000 were 25 and 3 times respectively more likely to take up insurance compared to those who earned an income of less than Kes 5,000 per month.

Conclusion: The proportion of slum residents without any type of insurance was high. Modifiable socioeconomic factors dominated possible reasons for uptake/ non-uptake of health insurance. Policies geared towards elevated human development index in the informal settlements are needed to increase coverage of health insurance.