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 therefore, the 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 specific objectives were to determine the proportion of informal sector workers that enrolled for Medical Insurance Scheme in the past three year; to establish the sources of money paid for Health services at the point of use among the informal sector workers and to identify factors that influence uptake of Health Insurance Schemes among informal sector workers. The study site was Matuu Ward, Machakos County and the target population was informal workers. The study design was analytical cross sectional study which applied a mixed method approach in data collection and analysis. The inclusion criteria was employers and employees in the informal sector. The exclusion criteria was minors below 18 years of age. 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. Proportionate sampling technique was then employed to establish how many respondents were to be sampled under each stratum/category. 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 analyzed and then grouped into themes and sub-themes. Ethical considerations were observed. The study found that 97% of the respondents 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 (p=0.000) 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. Uptake of health insurance offered by private insurance firms was low due to high premiums, bearing in mind that most of the informal sector workers earn very low and irregular incomes. 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.