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Methods: The study used data from the 2008-09 KDHS, a nationally representative survey. Descriptive statistics and multivariate logistic regression analysis were used to describe the characteristics of the sample and to identify factors associated with health insurance coverage. Separate analyses were performed for men and women.
Results: Only 7% of women and 12% of men had health insurance. A higher proportion of those who had insurance were covered by employer-based health insurance (4% of women and 8% of men), while less than 1% were covered by community-based health insurance schemes. In both genders, being employed in the formal sector, being married, having secondary education and higher, and belonging to the middle and rich wealth status categories were associated with having health insurance. The multivariate results also highlighted important gender differences associated with health insurance coverage. Women residing in female-headed households were more likely (OR=1.5; p<0.01) to be insured compared to those in male-headed households. Men residing in households with 5 or more members were significantly less likely to have health insurance (OR=0.7; p<0.05) relative to those in households with 1-4 members.
Conclusions: The proportion of individuals without any type of insurance is high, which underscores the need for a social health insurance program to ensure equitable access to health care, particularly among the poor and vulnerable segments of the population. As the Kenyan government moves toward transforming the NHIF into a universal health program, it is important to implement a program that will increase equity and access to health care services by all population groups.
Word count: 300
Learning Objectives: 1) To demonstrate the high proportion of individuals without health insurance in Kenya 2) To highlight factors associated with health insurance coverage 3) To provide evidence that policymakers can utilize in developing evidence-based policies aimed at increasing health insurance coverage