Influence of socio-economic factors on utilization of healthcare services in informal settlements: a case of health projects in Kibera Slum, Nairobi County

Abstract

This research sought to demystify the influence of socio-economic factors on utilization of healthcare services in Kenya’s informal settlements using community health projects in Kibera slum in Nairobi County. The study sought to investigate the five related objectives which included: to examine the influence of levels of income on health-care seeking behavior in informal settlements in Kenya, to establish the influence of literacy levels on health-care seeking behavior in informal settlements in Kenya, to verify the influence of levels of poverty on healthcare seeking behavior in informal settlements in Kenya, ascertain the influence of gender on health-care seeking behavior on informal settlements in Kenya and to determine the combined influence of socio-economic factors on health-care seeking behavior in informal settlements in Kenya. The study delimited itself to the four ongoing projects which included Kibera Water and Sanitation Project, Kibera Global Giving Project, Kibera Community Integrated Health Program and Kibera Better Options Project. The target population for this study was 500 households supported by the four projects under study. The sample size for this study was 154 households that were determined by the use of the simplified Yamane, (1967) formula of proportions. A structured questionnaire was the main tool used to collect the required data. The structured questionnaire contained 6 sections with 15 questions. The validity of the questionnaire was established through construct validity while reliability of the questionnaire was established through Cronbach’s Alpha and found to be 0.7475 meaning the questionnaire was therefore reliable. Pilot-testing of the questionnaire was undertaken on households in Mashimoni village that were deliberately excluded from the main study. Pilot testing process was crucial in helping to refine the questionnaire mechanics and remove inconsistencies and errors. This research adopted descriptive survey design so as to describe the characteristics of targeted households, estimate the proportion of people with certain characteristics and make predictions on utilization of healthcare services. This design was used due to its ability to ensure minimization of bias and maximization of the reliability of evidence so collected. Data obtained was analyzed using statistical package for social sciences (SPSS) Version 21.0.Qualitative data was analyzed by making inferences from expressions and opinions of the respondents around the themes and presented descriptively through content analysis. Findings were presented in frequency tables and explanations followed in prose. From the regression models undertaken there was a highly significant relationship (with t statistic p value <0.001 < 0.05) between the level of income and utilization of healthcare services. Again there existed a highly significant relationship (with t statistic p value <0.0035 < 0.05) between level of poverty and the utilization of health care services. There was somewhat significant relationship significant relationship (with t statistic p value <0.0045 < 0.05) between literacy level and the utilization of healthcare services. However there was no any relationship between gender (p = 0.220 > 0.05) and the utilization of healthcare services. Meaning this study adopts accept the 1st, 2nd and 3rd hypothesis and rejects the 4th hypotheses respectively. From the multiple regression model, this relationship is depicted as Y= 4.00+ 0.001X1+ 0.0035X2+ 0.0045X3+ 0.220X4 +B0. In essence therefore, this study recommends that deliberate efforts should be placed on income levels, boosting literacy and reduction of poverty levels if utilization of health care services is to improve in informal settlements in Kenya.