Assessment of Health Insurance Schemes Uptake by the Informal Sector Workers at Matuu, Machakos County, Kenya

Abstract

Health Insurance is a social protection against the possibility of incurring medical expenditure among individuals. It is a critical pillar of Health care financing and the main driver in achieving Universal Health coverage in most nations. The core objective of the study was to assess the level of current uptake of Health Insurance among informal sector workers in Matuu Ward within Machakos County. The target population were the informal workers in Matuu, Machakos County. The study research design was analytical cross sectional study which applied a mixed method approach in data collection and analysis. The mixed method was used to contribute to answering of the research questions and provide stronger evidence for corroboration of findings through triangulation. A sample of 202 respondents was selected for this study and primary quantitative data was obtained from sampled individuals involved in enterprises by use of questionnaires. Descriptive data analysis was done and categorical variables in form of frequencies and percentages was done; while numerical variables in form mean, standard deviation was done in analyzing and presenting the data. Qualitative data from key informants was manually analyzed and then grouped into themes and sub-themes. The study established that at 97% were aware of the health insurance and in addition, only 31% of the respondents were aware of the Universal Health Care (UHC) which is being piloted in Machakos County. The major source of information on health insurance schemes was friends as reported by 41.1% of the respondents. The major reason for stopping payments was loss of main source of income as reported by 41.7%. Chi-square results indicated that gender, age, level of education and income level had no significant effect on uptake of insurance. However, marital status had a significant effect on uptake of insurance. In conclusion, the uptake of health insurance by informal sector workers is high especially with the NHIF. This is because the Government has been aggressively improving the uptake by NHIF by all in the Country to facilitate access to Health Services. On the other hand, uptake of health insurance offered by private insurance firms is still low due to high premiums, bearing in mind that most of the informal sector workers earn very low and irregular incomes. Majority the informal sector workers deem health insurance coverage as important and feel that it should be encouraged as part of the efforts of facilitating Universal Health Coverage. The study recommends that the Government should make health insurance uptake continuity more attractive to the informal sector workers. Government and the private sector should explore Public Private Partnership in provision of health insurance with the aim of promoting the contribution of private health insurance schemes in expanding Universal Health Coverage. Lastly, the government should have tax incentive such as tax breaks or waiver for the informal sector workers who are insurance holders to encourage continuity.

Keywords: Health Insurance Schemes, Informal Sector Workers, Kenya