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BMC Health Services Research

, 16:686

Health systems and services in low and middle income settings

Abstract

BackgroundAccess to affordable and effective health care is a challenge in low- and middle- income countries. Out-of-pocket expenditure for health care is a major cause of impoverishment. One way to facilitate access and overcome catastrophic expenditure is through a health insurance mechanism, whereby risks are shared and financial inputs pooled by way of contributions. This study examined factors that influenced the enrolment status of dairy farmers in Western Kenya to a community health insurance CHI scheme.

MethodsQuantitative, cross-sectional research was used to describe factors influencing the enrolment in the CHI scheme. Quota and convenience sampling was used, recruiting a sample of 135 farmers who supply milk to a dairy cooperation. Data were collected using a structured interview schedule and analysed using Stata SE, Data Analysis and Statistical Software, Version 12.

ResultsFactors influencing non-enrolment were identified as affordability 40%; n = 47, unfamiliarity with the management of the scheme 37%; n = 44 and a lack of understanding about the scheme 41%; n = 48. An exploratory factor analysis was used to reduce the variables to two factors: information provision and understanding community health insurance CHI. Logistic regression identified factors associated with enrolment in the Tanykina Community Healthcare Plan TCHP. Supplies of less than six litres of milk per day OR: 0.22; 95% CI: 0.06–0.84 and information provision OR: 8.77; 95% CI: 2.25–34.16 were significantly associated with enrolment in the TCHP.

Nearly 30% 29.6%; n = 40 of the respondents remarked that TCHP is expensive and 17% n = 23 asked for more education on CHI and TCHP in an open-ended question.

ConclusionRecommendations related to marketing strategies, financial approach, information provision and further research were outlined to be made to the management of the TCHP as well as to those involved in public health.

KeywordsAccess to community health insurance Dairy farmers Enrolment status Information provision AbbreviationsAARAfrican Air Rescue

CHICommunity health insurance

CIConfidence interval

KMOKeiser-Meyer-Olkin

KShKenyan Shilling

NHINational Health Insurance

OROdd’s ratio

PCAPrincipal components analysis

SESSocio-economic status

TCHPTanykina Community Healthcare Plan

TDPLTanykina Dairy Plant Ltd

THETotal health expenditure

WHOWorld Health Organization

Electronic supplementary materialThe online version of this article doi:10.1186-s12913-016-1925-1 contains supplementary material, which is available to authorized users.

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Autor: Tineke de Groot-de Greef - Lydia V. Monareng - Janetta H Roos

Fuente: https://link.springer.com/







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