Abstract:
Arising from the global practice and WHO recommendations, extending access to
health care to all segments of the population, including the poor is an important
objective of the Kenyan Government’s National Health-Sector Strategic Plan and
National Development Agenda as outlined in the Kenya Vision 2030 policy
framework (Ministry of Health, 2015). Health insurance is deemed as a means of
protecting individuals from incurring high costs at times of illness. It is a potential
mechanism for overcoming existing health inequities with consequent effort to
promote uptake among the citizens as a way of promoting healthcare. This study
examined the factors associated with uptake of healthcare insurance among
patients seeking care at Moi Teaching and Referral Hospital, Eldoret, Kenya. A
descriptive cross sectional-survey design was adopted involving 234 in-patients
and out-patients seeking care at Moi Teaching and Referral Hospital. Stratified
and Systematic sampling techniques were applied. Data was collected using
structured questionnaires, coded, cleaned and entered into STATA (version 13) for
analysis. Descriptive statistics were generated and bivariate analysis to determine
factors associated with healthcare insurance uptake were carried out using OR and
the Chi-square test. A multiple-logistic model was fitted to adjust for relationships.
The study found out that uptake of healthcare insurance cover was a significantly
associated with education level, marital status, income of the patients and level of
awareness. Uptake of healthcare insurance cover was high among the old (Median
= 35, IQR 29, 42) compared to the young (Median = 32, IQR 24, 40), p=0.013.
Awareness about of healthcare insurance was associated with, p<0.001, while
gender disparity did not show any differentials in uptake, p=0.163. The study
concluded that males and the elderly were more likely to be enrolled in healthcare
insurance schemes than females and the young. In addition, marital status and
education level of an individual positively influenced uptake of healthcare
insurance. However, the association between gender and healthcare insurance was
not significant. The study further concluded that respondents with higher incomes
had a higher likelihood of enrolling in a healthcare insurance scheme as compared
to individuals with low income. Awareness about healthcare insurance schemes
increased uptake of healthcare insurance. The study recommends the need to
encourage women, the unmarried and the young to enroll in healthcare insurance
schemes. In addition, insurance agents need to target people with low education
levels to scale up uptake and further, healthcare insurance providers to tailor
affordable products consistent with income differentials.