Ontology highlight
ABSTRACT: Objective
To determine the prevalence of health insurance and associated factors among households in urban slum settings in Nairobi, Kenya.Design
The data for this study are from a cross-sectional survey of adults aged 18 years or older from randomly selected households in Viwandani slums (Nairobi, Kenya). Respondents participated in the Lown scholars' study conducted between June and July 2018.Setting
The Lown scholars' survey was nested in the Nairobi Urban Health and Demographic Surveillance System in Viwandani slums in Nairobi, Kenya.Participants
A total of 300 randomly sampled households participated in the survey. The study respondents comprised of either the household head, their spouses or credible adult household members.Primary outcome measure
The primary outcome of this study was enrolment in a health insurance programme. The households were classified into two groups: those having at least one member covered by health insurance and those without any health insurance cover.Results
The prevalence of health insurance in the sample was 43%. Being unemployed (adjusted OR (aOR) 0.17; p<0.05; 95% CI 0.06 to 0.47) and seeking care from a public health facility (aOR 0.50; p<0.05; 95% CI 0.28 to 0.89) was significantly associated with lower odds of having a health insurance cover. The odds of having a health insurance cover were significantly lower among respondents who perceived their health status as good (aOR 0.62; p<0.05; 95% CI 1.17 to 5.66) and those who were unsatisfied with the cost of seeking primary care (aOR 0.34; p<0.05; 95% CI 0.17 to 0.69).Conclusions
Health insurance coverage in Viwandani slums in Nairobi, Kenya, is low. As universal health coverage becomes the growing focus of Kenya's 'Big Four Agenda' for socioeconomic transformation, integrating enabling and need factors in the design of the national health insurance package may scale-up social health protection.
SUBMITTER: Otieno PO
PROVIDER: S-EPMC6924758 | biostudies-literature | 2019 Dec
REPOSITORIES: biostudies-literature
Otieno Peter O PO Wambiya Elvis Omondi Achach EOA Mohamed Shukri F SF Donfouet Hermann Pythagore Pierre HPP Mutua Martin K MK
BMJ open 20191215 12
<h4>Objective</h4>To determine the prevalence of health insurance and associated factors among households in urban slum settings in Nairobi, Kenya.<h4>Design</h4>The data for this study are from a cross-sectional survey of adults aged 18 years or older from randomly selected households in Viwandani slums (Nairobi, Kenya). Respondents participated in the Lown scholars' study conducted between June and July 2018.<h4>Setting</h4>The Lown scholars' survey was nested in the Nairobi Urban Health and D ...[more]