Financing and availability of essential medicines before and after introduction of the national hospital insurance fund civil servants and disciplined services medical scheme at Webuye District Hospital, Kenya

Abstract

Background: Financing is an important determinant of access to essential medicines. In Kenya, the National Hospital Insurance Fund Civil Servants and Disciplined Services Medical Scheme is a key contributor to financing the procurement of essential medicines. Main Objective: To compare availability and funding of essential medicines at Webuye District Hospital, Kenya before and after implementation of the new National Hospital Insurance Fund Medical Scheme. Methods: This was a longitudinal before-after study of four years (January 2010-December 2013); the latter two of which the scheme was in operation. Results: After introduction of the scheme, there was a higher allocation for the medicines budget from the Facility Improvement Fund, which hosts finances from the National Hospital Insurance Fund (p=0.008). The actual expenditure on essential medicines was also higher. Expenditure on essential medicines by the government, reduced (p<0.0001). The stock out rate decreased by 2.28% though this change was not statistically significant (p=0.099). The Facility Improvement Fund expenditure on essential medicines was a significant negative predictor of stock out rate. Conclusion: Although financing of medicines through the facility improvement fund increased after introduction of the new scheme, there was no change in the stock-out rate.