Access to health care: the role of a community based health insurance in Kenya

Out-of-pocket payments create financial barriers to health care access. There is an increasing interest in the role of community based health insurance schemes in improving equity and access of the poor to essential health care. The aim of this study was to assess the impact of Jamii Bora Health Insurance (JBHI) on access to health care among the urban poor in Kenya.

Data was obtained from the household health interview survey in Kibera and Mathare slums, which consisted of 420 respondents, aged 18 and above who were registered as members of Jamii Bora Trust. The members of Jamii Bora Trust were divided into two groups the insured and the non-insured.

The article found that:

• in total, 17.9 per cent respondents were hospitalised and women (19.6 per cent ) were more likely to be admitted than men (14.7 per cent )
• those in the poorest quintile had the highest probability of admission (18.1 per cent )
• those with secondary school education, large household size, and aged 50 and above also had slightly greater probability of admission (p<0.25)
• 86 per cent of admissions among the insured respondents were covered JBHI and those in the poorest quintile were more likely to use the JBHI benefit
• results from the logistic regression revealed that the probability of being admitted, whether overall admission or admission covered by the JBHI benefit was determined by the presence of chronic condition (p<0.01).

The artcile concludes that utilisation and take up of the JBHI benefits was high. Overall, JBHI favoured the members in the lower income quintiles who were more likely to use health care services covered by the JBHI scheme.