Social Health Insurance Contribution Payment Options Among Informal Sector Workers in Eastlands Area of Nairobi County

Abstract

Health insurance payment options are platforms that facilitate voluntary contributions to health Insurance. However, there are few, if any, studies on accessibility, efficiency and effectiveness of these platforms among informal sector workers (ISWs). There is limited understanding of attitudes and beliefs, social pressure and technology around these payment options. This study fills this gap by examining what motivates the ISWs to choose the various payment options for contributing to the National Hospital Insurance Fund (NHIF) and how choice of payment options is influenced by attitudes and beliefs, social pressure and technology. Data was collected through interview guides, key informant interviews and focus group discussions. The findings show that M-pesa is the preferred contribution platform followed by over the counter banking while the NHIF electronic wallet application had no users. The study finds that there are several challenges associated with the payment options such as transaction errors linked to use of the NHIF account number instead of the national identification number when transacting contributions through M-pesa. The research also revealed determinants of the different payment options for example, getting receipts from banks as proof of payment was found to influence the choice of over the counter banking. In addition, advice from NHIF staff was found to be the most influential social pressure among the informal sector workers and their choice of payment option. The research found a relationship between attitudes and beliefs, social pressure, and choice of payment options. Overall, the payment options reviewed in this study showed under-utilization of the available payment platforms especially the electronic wallet application. This suggests that there is potential to expand accessibility, increase efficiency as well as simplify the interaction between informal sector workers and the national health insurance fund in Kenya.