Uptake Of Health Insurance Among Patients Attending Public And Private Hospitals In Embu County, Kenya

ABSTRACT

Health insurance has been considered as key to achieving universal health care by various countries. This is with the aim of ensuring that every citizen should have access to needed healthcare services that are effective and of acceptable quality and that no one should risk financial ruins as a result of illness. However, recent statistics still indicate that in Kenya, currently 26.6% of total health expenditure is out of pocket. Out-of-pocket spending on healthcare has been found to drive the poor into more poverty and poses a barrier to their access to healthcare. This study aimed at determining the uptake of health insurance among patients attending public and private hospitals in Embu. The objectives of the study were to determine the extent of uptake of health insurance among patients attending public and private hospitals in Embu County, to determine the factors influencing uptake of health insurance, the preferred type of health insurance scheme between private and public health insurance and the level of satisfaction for those already having health insurance cover. The independent variables in this study were socioeconomic factors, the available health insurance providers, the preferred health insurance provider and client’s satisfaction. The dependent variable for the study was uptake of health insurance which was determined by the extent of health insurance uptake. The study was carried out in Embu County in both public and private hospitals. Embu County has seven public hospitals and one private hospital according to WHO definition of a hospital. The study was a descriptive cross-sectional study. The sample size was (n=384) which was determined through the formula n = Z2 p(1- p)/d2 . Respondents were sampled through stratified random sampling method where eight hospitals formed the stratum. Data was collected by use of self and researcher administered questionnaires by the researcher for a period of two weeks. Collected data was analyzed using SPSS version 20 to draw both descriptive and inferential statistics. Uptake of health insurance was found to be 46.1% majority of them being those employed in the formal sector, and also majority being covered by NHIF. Level of knowledge on health insurance was found to be 52.6%, which could be a major factor contributing to low uptake. Significant relationship was found between gender, level of education and marital status and level of uptake of health insurance. Employment status, nature of employment and terms of employment were also found to influence uptake of health insurance. Despite high uptake being on public health insurance, majority of the population preferred private health insurance. The study drew conclusion that level of uptake of health insurance was low, uptake was being influence by gender, level of education, marital status, and status, nature and terms of employment. The study recommended that there is need for intensified efforts to raise people’s knowledge on health insurance and its uptake, to improve the flexibility of features of NHIF to integrate more of those working in the informal sector, the public health insurance companies to improve their service delivery