National Hospital Insurance Fund Enrolment in Uasin Gishu County, Kenya

Background: Despite the establishment of NHIF in 1966 to provide access to healthcare for all, enrolment in Uasin Gishu remains low. The low enrolment led to out-of-pocket payments which were a deterrent to seeking health care. Objective: This study aimed to identify the determinants of uptake of NHIF among residents of Kapyemit, in Uasin Gishu County, Kenya. Methodology: A cross-sectional study was done with a sample (N=334), selected using stratified random sampling. Questionnaires were pre-tested and Key-Informant interviews were done to collect data. Data analysis: Data was analyzed using SPSS version 20 and Pearson’s Chi-square test at 95% confidence interval to establish an association between the dependent and independent variables. The level of statistical significance was P-value <0.05. Multivariate regression was done to determine the independent factors associated with enrolment in NHIF. Findings: The findings revealed that enrolment into NHIF was at 35%. The factors that were associated with enrolment were: being married [OR 1.133; CI =0.227-5.648; p=0.879], tertiary education, [OR 3.862; CI = 1.347-11.074; p=0.012], professional occupation, [OR 1.978; CI = 0.679-5.766; p=0.211], having additional source of income, [OR =3.776; CI =1.656-8.611; p= 0.002], having regular monthly income [OR=1.524 CI= 0.087- 3.142; p=0.480], prefer private facilities, [OR=6.657 CI=1.790-24.758; p=0.005], good quality of care [OR=1.630; CI=0.890-2.985; p=0.113] and trust in scheme assed in a scale [OR=3.418; CI=1.866-6.261; p=0.000]. Recommendation: A multi-sectoral engagement in the redesign of the scheme would be necessary to make the scheme more responsive to the needs of the population.