| dc.description.abstract | Financing health care in the sub Saharan African region remains a pressing concern despite the rapid socio economic transformations in the health sector that have occurred since the early 1980s. Health insurance like other forms of insurance is a form of collectivism by means of which people collectively pull their risks in this case the risk of incurring in medical expenses. The government of Kenya realized how expensive health care was and how it would deny the poor from accessing appropriate health care, and it established National Hospital Insurance Fund (NHIF) in 1966 through an act of parliament to provide an in patient cover to all its Kenyan residents.
It is a statutory social insurance fund whose responsibility is to provide health insurance coverage for its members and their dependants. National Hospital Insurance Fund has concentrated mostly on the formal sector yet the informal sector plays a key role in the Kenyan economy but do not contribute as actively as required to NHIF. The purpose of the study was to establish factors influencing sustainability of informal sector's contributions towards NHIF. The study was guided by the following objectives that sought to explore how: demographic factors; socio-economic factors; sensitization levels; and health insurance legislation factors influence the sustainability of informal sector's contributions to NHIF in Kisumu municipality.
The study is hoped to be significant to NHIF and the government in the formulation and implementation of policies with regard to health insurance. The target population was the informal sector participants within Kisumu municipality. The sample size was 361 respondents from the informal sector within Kisumu municipality. Stratified random sampling was used to select respondents from the informal sector's diverse industries. A descriptive survey design was adopted and assisted questionnaires were used to collect both quantitative and qualitative data to answer the research questions. Four areas within Kisumu municipality were selected purposively for data collection for a period of two weeks.
Data collected for the study was reviewed and cleaned at collection point and every evening prior to entry into an MS Access data base in order to minimize errors of omission and commission. Statiscal package for social sciences (SPSS) version 12.0.1 was used to analyze the data in order to give descriptive statistics and presented in tables in the form of frequencies and percentages on how the various variables influenced the sustainability of informal sector's contribution to NHIF. With the Same SPSS, Chi-square tests were employed in preparation of cross tabulation and hypothesis testing of variables to generate significant test results. Qualitative data was transcribed, organized into various emerging themes and reported verbatim.
In conclusion, the study findings revealed that demographic characteristics, low income, poor sensitization levels and in appropriate health insurance legislations influenced the sustainability of informal sector's contribution to NHIF in Kisumu municipality. The study recommends NHIF to contract community based organizations to recruit and collect contributions on behalf of NHIF.A multi prolonged awareness creation strategy would go a long way to ensure a well informed community with respect to health insurance. Further research is suggested on challenges facing the implementation of the legislation to increase the NHIF contribution rate, the impact of computer based information system in the management of NHIF operations and the management of funds contributed by the informal sector. | en_US |
