Background
Background on health insurance in Kenya
Methods
Study population and sampling
Data analysis
Variable | Operational definition |
---|---|
Dependent variable | |
Enrolment in NHIF | Yes = 1 and No = 0 |
Key independent variables
| |
Type of employment sector | 1 = Formal sector and 0 = Informal sector |
Participation in the National Social Security Fund (NSSF) | Yes = 1 and No = 0 |
Participation in savings and credit cooperative organizations (SACCOs) | Yes = 1 and No = 0 |
Participation in community-based savings groups | Yes = 1 and No = 0 |
Other independent variables
| |
Income in the last one montha
| 0 = Non-poor, 1 = Poor, and 2 = Don't know/missing |
Gender | 1 = Female and 0 = Men |
Marital status | 1 = Currently in union, 2 = Formerly in union, and 3 = Never in union |
Age of respondents | 0 = Less than 24 years, 1 = 24-29 years, 2 = 30-39 years, 3 = 40-49 years, and 4 = 50+ years |
Education | 0 = Never attended school, 1 = Primary, and 2 = Secondary/higher |
Slum residence | 0 = Viwandani and 1 = Korogocho |
Ethnicity | 0 = Kikuyu, 1 = Luhya, 2 = Luo, 3 = Kamba, and 4 = Other |
Ethical considerations
Results
Descriptive analysis
Enrolled in NHIF | ||||
---|---|---|---|---|
Yes | No | |||
Variables | Total Number | N (%) | N (%) |
p-values |
Employment sector
| ||||
Formal employment | 3,007 | 1,434 (47.69) | 1,573 (52.31) | *** |
Informal employment | 6,000 | 180 (3.00) | 2,113 (97.00) | |
Participates in National Social Security Fund (NSSF)
| ||||
Yes | 1,982 | 1,608 (81.13) | 374 (18.87) | *** |
No | 14,358 | 137 (0.95) | 14,221 (99.05) | |
Participates in savings and credit cooperative organizations (SACCOs)
| ||||
Yes | 517 | 465 (89.94) | 52 (10.06) | *** |
No | 15,821 | 1,280 (8.09) | 14,541 (91.91) | |
Participates in community-based savings groups
| ||||
Yes | 2,328 | 493 (21.18) | 1,835 (78.82) | *** |
No | 14,012 | 1,251 (8.93) | 12,761 (91.07) | |
Income in the last one month
| ||||
Poor | 2,510 | 60 (2.39) | 2,450 (97.61) | *** |
Non-poor | 5,827 | 1,408 (24.16) | 4,419(75.84) | |
Don't know/missing | 667 | 145 (21.74) | 522 (78.26) | |
Gender
| ||||
Male | 8,699 | 1,413 (16.24) | 7,286 (83.76) | *** |
Female | 7,643 | 332 (4.34) | 7,311 (95.66) | |
Marital status
| ||||
Currently in union | 7,399 | 1,190 (16.08) | 6,209 (83.92) | *** |
Formerly in union | 907 | 42 (4.63) | 865 (95.37) | |
Never in union | 4,989 | 171 (3.43) | 4,818 (96.57) | |
Age of respondents
| ||||
Less than 24 years | 3,992 | 45 (1.13) | 3,947 (98.87) | *** |
24-29 years | 3,096 | 177 (5.72) | 2,919 (94.28) | |
30-39 years | 4,213 | 638 (15.14) | 3,575 (84.86) | |
40-49 years | 2,174 | 437 (20.10) | 1,737 (79.90) | |
50+ years | 2,867 | 448 (15.63) | 2,419 (84.37) | |
Education
| ||||
Never attended school | 1,123 | 33 (2.94) | 1,090 (97.06) | *** |
Primary | 10,540 | 801 (7.60) | 9,739 (92.40) | |
Secondary/higher | 4,327 | 871 (20.13) | 3,456 (79.87) | |
Slum residence
| ||||
Korogocho | 7,741 | 207 (2.67) | 7,534 (97.33) | *** |
Viwandani | 8,601 | 1,538 (17.88) | 7,063 (82.12) | |
Ethnicity
| ||||
Kikuyu | 5,535 | 347 (6.27) | 5,188 (93.73) | *** |
Luhya | 2,210 | 252 (11.40) | 1,958 (88.60) | |
Luo | 2,394 | 142 (5.93) | 2,252 (94.07) | |
Kamba | 3,871 | 756 (19.53) | 3,115 (80.47) | |
Other | 2,302 | 247 (10.73) | 2,055 (89.27) |
Multivariate analysis
Variables | Public Health Insurance Status | |||
---|---|---|---|---|
Unadjusted OR (UOR) | 95% CI | Adjusted OR (AOR) | 95% CI | |
Employment sector (
Ref = Informal employment)
| ||||
Formal employment | 29.47*** | [25.00-34.75] | 4.11*** | [1.57-3.58] |
Participates in National Social Security Fund (NSSF) (Ref = No)
| 446.29*** | [364.51-546.42] | 222.63*** | [152.34-325.35] |
Participates in savings and credit cooperative organizations (SACCOs) (Ref = No)
| 101.58*** | [75.84-136.06] | 14.48*** | [7.48-28.03] |
Participates in community-based savings groups (Ref = No)
| 2.74*** | [2.44-3.07] | 1.62** | [1.15-2.28] |
Income in the last one month
a
(Ref = Non-poor)
| ||||
Poor | 0.07*** | [0.05-0.09] | 0.34*** | [0.20-0.57] |
Gender
(Ref = Male)
| ||||
Female | 0.23*** | [0.20-0.26] | 2.37*** | [1.57-3.58] |
Marital status
(Ref = Currently in Union)
| ||||
Formerly in union | 0.25*** | [0.18-0.34] | 0.46* | [0.23-0.94] |
Never in union | 0.18*** | [0.15-0.21] | 0.57* | [0.36-0.90] |
Age of respondents
(Ref = Less Than 24 Years)
| ||||
24-29 years | 5.31*** | [3.82-7.40] | 0.83 | [0.24-2.82] |
30-39 years | 15.65*** | [11.53-21.24] | 0.76 | [0.22-2.56] |
40-49 years | 22.06** | [16.15-30.14] | 1.02 | [0.29-3.54] |
50+ years | 16.24*** | [11.90-22.16] | 0.75 | [0.21-2.63] |
Education
(Ref = Never Attended School)
| ||||
Primary | 2.71*** | [1.90-3.86] | 2.07 | [0.88-4.86] |
Secondary/higher | 8.32*** | [5.84-11.86] | 2.12 | [0.89-5.04] |
Slum residence
(Ref = Viwandani)
| ||||
Korogocho | 0.12*** | [0.10-0.14] | 0.84 | [0.56-1.27] |
Ethnicity
(Ref = Other)
| ||||
Kikuyu | 1.92*** | [1.62-2.28] | 0.87 | [0.55-1.38] |
Luhya | 0.94 | [0.77-1.15] | 1.67 | [0.96-2.90] |
Luo | 3.62*** | [3.17-4.15] | 1.11 | [0.77-1.62] |
Kamba | 1.79*** | [1.51-2.13] | 1.09 | [0.68-1.76] |