Prevalence and factors associated with health insurance coverage in resource-poor urban settings in Nairobi, Kenya: a cross-sectional study

• Published in: BMJ open 2019-12, Vol.9 (12), p.e031543-e031543
• Main Authors: Otieno, Peter O, Wambiya, Elvis Omondi Achach, Mohamed, Shukri F, Donfouet, Hermann Pythagore Pierre, Mutua, Martin K
• Format: Article
• Language: English
• Subjects: Cross-sectional studies; Data collection; Employment; Ghettos; Health care policy; Health insurance; Health Policy; Households; Informal economy; Insurance coverage; Low income groups; primary care; Principal components analysis; Public health; Sample size; Settlements & damages; Software; Sustainability; universal health coverage; urban slums; Variables
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2019-031543

ObjectiveTo determine the prevalence of health insurance and associated factors among households in urban slum settings in Nairobi, Kenya.DesignThe data for this study are from a cross-sectional survey of adults aged 18 years or older from randomly selected households in Viwandani slums (Nairobi, Kenya). Respondents participated in the Lown scholars’ study conducted between June and July 2018.SettingThe Lown scholars’ survey was nested in the Nairobi Urban Health and Demographic Surveillance System in Viwandani slums in Nairobi, Kenya.ParticipantsA total of 300 randomly sampled households participated in the survey. The study respondents comprised of either the household head, their spouses or credible adult household members.Primary outcome measureThe primary outcome of this study was enrolment in a health insurance programme. The households were classified into two groups: those having at least one member covered by health insurance and those without any health insurance cover.ResultsThe prevalence of health insurance in the sample was 43%. Being unemployed (adjusted OR (aOR) 0.17; p