Poverty and health care demand in Kenya

Awiti, J

doi:10.1186/s12913-014-0560-y

Cited by 41 publications

(50 citation statements)

References 52 publications

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“…Households with an educated head were less likely to forgo care due to cost. Furthermore, lack of formal education is seen as a predictor of poverty given education opens up a range of income-generating opportunities [60]. Other studies have also reported lower levels of education increases the odds of having unmet need [61].…”

Section: Discussionmentioning

confidence: 99%

Cost–related unmet need for healthcare services in Kenya

Njagi

Arsenijevic

Groot

2020

BMC Health Serv Res

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Background: The assessment of unmet need is one way to gauge inequities in access to healthcare services. While there are multiple reasons for unmet need, financial barriers are a major reason particularly in low-and middleincome countries where healthcare systems do not offer financial protection. Moreover, accessibility and affordability are paramount in achieving universal health coverage. This study examines the extent of unmet need in Kenya due to financial barriers, the associated determinants, and the influence of regional variations. Methods: We use data from the 2013 Kenya household health expenditure and utilization (KHHEUS) cross sectional survey. Self-reported unmet need due to lack of money and high costs of care is used to compute the outcome of interest. A multilevel regression model is employed to assess the determinants of cost-related unmet need, confounding for the effect of variations at the regional level. Results: Cost-related barriers are the main cause of unmet need for outpatient and inpatient services, with wide variations across the counties. A positive association between county poverty rates and cost-related unmet is noted. Results reveal a higher intraclass correlation coefficient (ICC) of 0.359(35.9%) for inpatient services relative to 0.091(9.1%) for outpatient services. Overall, differences between counties accounted for 9.4% (ICC~0.094) of the total variance in cost-related unmet need. Factors that positively influence cost-related unmet need include older household heads, inpatient services, and urban residence. Education of household head, good self-rated health, larger household size, insured households, and higher wealth quintiles are negatively associated with cost-related unmet need. Conclusion: The findings underscore the important role of cost in enabling access to healthcare services. The county level is seen to have a significant influence on cost-related unmet need. The variations noted in cost-related unmet need across the counties signify the existence of wide disparities within and between counties. Scaling up of health financing mechanisms would fundamentally require a multi-layered approach with a focus on the relatively poor counties to address the variations in access. Further segmentation of the population for better targeting of health financing policies is paramount, to address equity in access for the most vulnerable and marginalized populations.

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Section: Discussionmentioning

confidence: 99%

Cost–related unmet need for healthcare services in Kenya

Njagi

Arsenijevic

Groot

2020

BMC Health Serv Res

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“…Introduction Achieving the best health status possible is one of the most important social goals world-wide. This is because health is a human right as well as a valued asset necessary for improved productivity (Awiti, 2014). In case of poor health, an individual is faced with a wide variety of actions that he/she can undertake to improve health.…”

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confidence: 99%

An Empirical Analysis of the Effect of Poverty on Health Care Utilization in Kenya

Musyoka

Korir

Omolo

et al. 2018

ESJ

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Background Good health is a fundamental huma right, a valued asset, and a prerequisite for improved productivity. However, high poverty can lead to under utilization or lack of utilization of health care leading to poor health. Thus, poverty reduction and improvement of health care utilization are important in ensuring enjoyment of good health. Since 1982, poverty has remained above 40 per cent despite Kenya’s commitment to poverty reduction. Kenya’s health indicators have also not been impressive and health care utilization has remained low. Evidence shows that those who fell sick and reported lack of finances as the main reason for not seeking medical attention constituted 44 per cent, 38 per cent and 21.4 per cent in 2003, 2007 and 2013, respectively. These statistics point to poor health care utilization due to poverty. In Kenya, studies have concentrated on small segments of the population or parts of the country hence limiting generalization of the findings. Objective The objective of this paper was to determine the effect of poverty on health care utilization in Kenya. Method The study used a Negative Binomial Regression and the 2013 Kenya Household Expenditure and Utilization Survey dataset. The study also used Two Stage Residual Inclusion approach and a Control Function Approach to test and control for potential endogeneity and unobserved heterogeneity problems, respectively. Results The estimation results showed that reduction in poverty increased health care utilization. Other factors that had a positive and statistically significant effect on health care utilization were household size, early levels of education, and distance to the nearest health facility. Conclusion The study concludes that health care utilization is negatively affected by poverty other factors held constant. Thus, policies and strategies aimed at reducing poverty are needed. In particular the study recommends introduction of universal health care for all.

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“…For instance, in Kenya, poverty reduced the probability of infants and children aged 1-14 from visiting modern healthcare facilities. [19] Poverty is a barrier to the poor in accessing healthcare services in developing countries. [20] Where there are no social health insurance schemes for low-income earners, remittances serve as a substitute for those that have international migrants that are sending money to them.…”

Section: Discussionmentioning

confidence: 99%

Impact of remittances on healthcare utilisation and expenditure in developing countries: a systematic review

Nathaniel¹

2020

Rwanda Journal of Medicine and Health Sciences

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Background The poor and low-income earners used remittances to access healthcare services because most of them are not covered by private or government health insurance schemes.The money sent by migrant workers from abroad to their family members, relatives and friends serves as social protection, especially in developing countries where there are no standardised social protection programmes. Objective This review assesses the impact of remittances on healthcare utilisation and expenditure in developing countries. Methods A systematic search for relevant literature was conducted online for studies published between 2002 and 2018. Results The inclusion criteria of the study were met by 7 out of the 135 studies searched electronically. The studies conducted in Africa, Asia, Europe and Latin America, found that remittances contributed toincreased healthcare access, utilisation and expenditures. However, the degrees of these impacts were limited among the studies except in Armenia, where remittances significantly increased healthcare utilisation. Conclusion Although remittances can not serve as an alternative to formal healthcare insurance schemes, they can serve as a short-term measure in healthcare utilisation in developing countries. It is the responsibility of governments at all levels to formulate health policies that will embrace universal healthcare coverage for all citizens.

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Poverty and health care demand in Kenya

Cited by 41 publications

References 52 publications

Cost–related unmet need for healthcare services in Kenya

Cost–related unmet need for healthcare services in Kenya

An Empirical Analysis of the Effect of Poverty on Health Care Utilization in Kenya

Impact of remittances on healthcare utilisation and expenditure in developing countries: a systematic review

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