Abstract:
Financial protection remains an important hurdle to overcome if
Universal Health Coverage is to be achieved in sub-Saharan Africa. An
innovative model of subsidised health insurance to vulnerable households
was implemented in one level four and two primary health care facilities
in Western Kenya. The project aimed to determine whether reduced
insurance costs, socioeconomic empowerment, and the availability of
drugs would improve patients' experience and encourage them to co-pay.
This was a secondary analysis of a mixed methods study with a cross-
sectional household survey consisting of 18 semi-structured interviews
conducted with NHIF subsidy program beneficiaries. Most beneficiaries
accessed care as a result of the program. However, challenges of
stockouts and inadequate healthcare workers persisted and discouraged
some of them from going to the participating facilities. Community
Health Promoters were very instrumental in enlightening the community
on the cover and getting the sick beneficiaries to go to the hospital. The
socioeconomic empowerment programme was beneficial but was mostly
long-term and required financial input from the community members
before they could sell the poultry or agricultural produce. Most
community members were willing to pay after receiving health services
using the cover. The study recommends contextualisation of
socioeconomic empowerment programs, which are very important in
enabling families to generate income to pay for health insurance.
Additionally, improving the service delivery experience is important by
reducing stockouts, having sufficient healthcare workers, and eliminating
facility-related delays, which would improve the confidence of
communities in public health facilities, thus retaining health insurance.