Devolution and healthcare services provision for women small scale traders in informal settlements in Nairobi Kenya

Abstract

In the current Kenya political dispensation, h ealth care is a devolved function. At the same time, the Kenya government is moving towards universal health coverage. Both situations, if implemented w ould guarantee access to health care by all Kenyans in all regions. This paper focus es on devolution and health care services provision for women small scale traders in urban informal settlements in Nairobi . The paper examine s whether women informal sectors workers have access to formal healthcare benefits that would guarantee them access to care when in need . The p aper is based on a study conducted in five urban informal settlements in Nairobi (Kibera, Mukuru, Mathare, Korogocho and Kawangware). D ata was collected through interviews with 398 women small scale traders (WSSTs), eight focus group discussion s a n d 34 key informant interviews. Results showed that only 28.4% WSSTs had enrolled in formal medical insurance schemes such as the National Hospital Insurance Fund (NHIF) and other private medical schemes . This low enrolment meant that m ost WSSTs relied on them selves and informal systems to meet their health needs. Despite this, the WSSTs were willing to join formal health insurance schemes if they were informed about the m and if the service providers agreed to go to the informal settlements to enrol them and collect contributions. The paper concludes that the constitutional right to health can be achieved if there is strategic focus on population groups in informal settlements . Mechanisms for working with informal sector workers and other marginalised gro ups should be develope d to enhance inclusiveness.