Perceptions and uptake of health insurance for maternal care in rural Kenya: a cross sectional study

Maina, Michuki; Kithuka, Peter; Tororei, Samuel

doi:10.11604/pamj.2016.23.125.8936

Cited by 25 publications

(34 citation statements)

References 13 publications

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“…In particular, poor financial protection in low resource settings is attributable to inadequate funding, fragmentation of healthcare resources, and inadequate health insurance coverage [16]. Similar to the findings of our study, previous studies have also shown that direct OOP costs place a huge burden of bearing the costs of illness to the sick person and their households, and is therefore, a major contributor to inequities [37][38][39][40][41]. Providing financial risk protection to reduce OOP health expenditure as envisaged in the Sustainable Development Goals and UHC agendas are critical to improving access to primary healthcare in resource-poor urban settings.…”

Section: Discussionsupporting

confidence: 82%

Access to primary healthcare services and associated factors in urban slums in Nairobi-Kenya

et al. 2020

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Background: Access to primary healthcare is crucial for the delivery of Kenya's universal health coverage policy. However, disparities in healthcare have proved to be the biggest challenge for implementing primary care in poorurban resource settings. In this study, we assessed the level of access to primary healthcare services and associated factors in urban slums in Nairobi-Kenya. Methods: The data were drawn from the Lown scholars' study of 300 randomly selected households in Viwandani slums (Nairobi, Kenya), between June and July 2018. Access to primary care was measured using Penchansky and Thomas' model. Access index was constructed using principal component analysis and recorded into tertiles with categories labeled as poor, moderate, and highest. Generalized ordinal logistic regression analysis was used to determine the factors associated with access to primary care. The adjusted odds ratios (AOR) and 95% confidence intervals were used to interpret the strength of associations. Results: The odds of being in the highest access tertile versus the combined categories of lowest and moderate access tertile were three times higher for males than female-headed households (AOR 3.05 [95% CI 1.47-6.37]; p < .05). Households with an average quarterly out-of-pocket healthcare expenditure of ≥USD 30 had significantly lower odds of being in the highest versus combined categories of lowest and moderate access tertile compared to those spending ≤ USD 5 (AOR 0.36 [95% CI 0.18-0.74]; p < .05). Households that sought primary care from private facilities had significantly higher odds of being in the highest versus combined categories of lowest and moderate access tertiles compared to those who sought care from public facilities (AOR 6.64 [95% CI 3.67-12.01]; p < .001). Conclusion: In Nairobi slums in Kenya, living in a female-headed household, seeking care from a public facility, and paying out-of-pocket for healthcare are significantly associated with low access to primary care. Therefore, the design of the UHC program in this setting should prioritize quality improvement in public health facilities and focus on policies that encourage economic empowerment of female-headed households to improve access to primary healthcare.

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Section: Discussionsupporting

confidence: 82%

Access to primary healthcare services and associated factors in urban slums in Nairobi-Kenya

et al. 2020

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“…In particular, poor financial protection in low resources settings is attributable to inadequate funding, fragmentation of healthcare resources and inadequate health insurance coverage (32). Similar to the findings of our study, previous studies have also shown that direct (out of pocket) OOP costs place a huge burden of bearing the costs of illness to the sick person and their households, and is, therefore, a major contributor to inequities (38)(39)(40)(41)(42). Providing financial risk protection to reduce OOP health expenditure as envisaged in the Sustainable Development Goals and UHC agendas is critical to improve access to primary healthcare in resource-poor urban settings.…”

Section: Discussionsupporting

confidence: 82%

Access to primary healthcare services and associated factors in urban slums in Nairobi-Kenya

Otieno

Wambiya

Mohamed

et al. 2019

Preprint

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Background: Access to primary healthcare is crucial for the delivery of Kenya’s universal health coverage policy. However, disparities in healthcare have proved to be the biggest challenge for implementing primary care in poor-urban resource settings. In this study, we assessed the level of access to primary healthcare services and associated factors in urban slums in Nairobi-Kenya. Methods: The data were drawn from the Lown scholars’ study of 300 randomly selected households in Viwandani slums (Nairobi, Kenya), between June and July 2018. Access to primary care was measured using Penchansky and Thomas’ model. Access index was constructed using principal component analysis and recoded into tertiles with categories labeled as poor, moderate and highest. Generalized ordinal logistic regression analysis was used to determine the factors associated with access to primary care. The adjusted odds ratios and 95 percent confident intervals were used to interpret the strength of associations. Results : The odds of being in the lowest versus combined moderate and highest access tertile were significantly higher for female than male-headed households (AOR 1.91 [95% CI 1.03-3.54]; p < .05). Households with an average quarterly out-of-pocket healthcare expenditure of ≥$30 had significantly lower odds of being in the lowest versus combined moderate and highest access tertile compared to those spending ≤ $5 quarterly (AOR 0.33 [95% CI 0.50-1.90]; p< .001). Households that sought care from private facilities had significantly higher odds of being in the lowest versus combined moderate and highest access compared to the public facilities (AOR 3.77 [95% CI 2.16-6.56]; p < .05). Conclusion : In Nairobi slums in Kenya, the gender of the household head, out of pocket healthcare expenditure, and source of primary care are significantly associated with access to primary care. Therefore, the universal health coverage program in this setting should be designed with an equity lens so that the most vulnerable groups within the community can have access.

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“…In particular, poor nancial protection in low resources settings is attributable to inadequate funding, fragmentation of healthcare resources, and inadequate health insurance coverage [34]. Similar to the ndings of our study, previous studies have also shown that direct (out of pocket) OOP costs place a huge burden of bearing the costs of illness to the sick person and their households, and is, therefore, a major contributor to inequities [40][41][42][43][44]. Providing nancial risk protection to reduce OOP health expenditure as envisaged in the Sustainable Development Goals and UHC agendas are critical to improving access to primary healthcare in resource-poor urban settings.…”

Section: Discussionsupporting

confidence: 82%

Access to primary healthcare services and associated factors in urban slums in Nairobi-Kenya

Otieno

Wambiya

Mohamed

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Access to primary healthcare is crucial for the delivery of Kenya’s universal health coverage policy. However, disparities in healthcare have proved to be the biggest challenge for implementing primary care in poor-urban resource settings. In this study, we assessed the level of access to primary healthcare services and associated factors in urban slums in Nairobi-Kenya. Methods: The data were drawn from the Lown scholars’ study of 300 randomly selected households in Viwandani slums (Nairobi, Kenya), between June and July 2018. Access to primary care was measured using Penchansky and Thomas’ model. Access index was constructed using principal component analysis and recorded into tertiles with categories labeled as poor, moderate, and highest. Generalized ordinal logistic regression analysis was used to determine the factors associated with access to primary care. The adjusted odds ratios (AOR) and 95 percent confidence intervals were used to interpret the strength of associations. Results: The odds of being in the highest access tertile versus the combined categories of lowest and moderate access tertile were 3.5 times higher for males than female-headed households (AOR 3.05 [95% CI 1.47-6.37]; p<.05). Households with an average quarterly out-of-pocket healthcare expenditure of ≥$30 had significantly lower odds of being in the highest versus combined categories of lowest and moderate access tertile compared to those spending ≤ $5.(AOR 0.36 [95% CI 0.18-0.74]; p<.05). Households that sought primary care from private facilities had significantly higher odds of being in the highest versus combined categories of lowest and moderate access tertiles compared to the public facilities (AOR 6.64 [95% CI 3.67-12.01]; p<.001). Conclusion: In Nairobi slums in Kenya, living in a female-headed household, seeking care from a public facility, and paying out of pocket for healthcare are significantly associated with low access to primary care. Therefore, the design of the UHC program in this setting should prioritize quality improvement in public health facilities and focus on policies that encourage economic empowerment of female-headed households to improve access to primary healthcare

show abstract

Perceptions and uptake of health insurance for maternal care in rural Kenya: a cross sectional study

Cited by 25 publications

References 13 publications

Access to primary healthcare services and associated factors in urban slums in Nairobi-Kenya

Access to primary healthcare services and associated factors in urban slums in Nairobi-Kenya

Access to primary healthcare services and associated factors in urban slums in Nairobi-Kenya

Access to primary healthcare services and associated factors in urban slums in Nairobi-Kenya

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