Health Insurance Deepening and Its Impact on Maternal Healthcare Demand in Private Hospitals in Kenya

Authors

  • George N. Mose Department of Sociology, Gender and Development Studies, Kisii University P.O. Box 408 – 40200 Kisii – Kenya
  • Joseph Abuga Orayo School of Business and Economics, Kisii University P.O. Box 408 – 40200 Kisii – Kenya

DOI:

https://doi.org/10.24297/jssr.v16i.8855

Keywords:

Private Hospitals, Maternal Healthcare Demand, Health Insurance

Abstract

Promotion of maternal healthcare services through the expansion of health insurance coverage has been a core strategy that has been adopted in the reduction of maternal and child mortalities in Kenya. In this study, we seek to establish how health insurance coverage and benefits influence the demand for maternal health utilization in private hospitals in Kenya. The study utilized the latest Kenya Demographic Household Survey 2014 data to estimate the relationship. The binary probit regression model was employed in estimation. From the findings, only 15 percent of mothers were enrolled in a health insurance plan, whereas 14 percent of the women reported to have attended antenatal clinics in private health facilities, and 13 percent benefited from skilled delivery in private healthcare facilities. Results further revealed that health insurance ownership led to a significant increase in the likelihood of utilizing maternal health care services in private hospitals in Kenya. Similarly, age of the mother, marital status, birth order, higher education level, all wealth index categories, and employment status were cofactors associated significantly with use of healthcare services. It was concluded that the advent and increase of health insurance coverage is associated with a significant rise in demand of maternal healthcare services in private hospitals. This study argues that the current health subsidies would be more effective if they were channeled through health insurance with wider coverage of private hospitals. The study recommends reforms in policies and guidelines governing insurance coverage, which we argue would significantly bring down the cost of insurance coverage, thus become more accessible to more Kenyans.

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References

Abor, P. A., Abekah‐Nkrumah, G., Sakyi, K., Adjasi, C. K., & Abor, J. (2011). The socio‐economic determinants of maternal health care utilization in Ghana. International Journal of Social Economics.

Andersen, R. M. (1995). Revisiting the behavioral model and access to medical care: does it matter?. Journal of health and social behavior, 1-10.

Andersen, R. (1968). A behavioral model of families' use of health services. A behavioral model of families' use of health services. (25).

Ani, K. (2013). Probit and Logit Models. Econometrics Academy Website: sites.google.com/site/econometricsacademy.

Burchi, F. (2009). On the contribution of mother’s education to children’s nutritional capabilities in Mozambique. Dipartimento di Economia Università degli Studi Roma Tre, Working Paper, 101, 1-34.

Caldwell, J. C. (1979). Education as a factor in mortality decline an examination of Nigerian data. Population studies, 395-413.

Hobcraft, J. (1993). Women's education, child welfare and child survival: a review of the evidence. Health Transition Review, 159-175.

Chepkoech, R. (2003). Demand for antenatal and obstetric care in Nairobi Slums (Unpublished Master of Arts Research Paper), University of Nairobi.

Chepkorir, J., (2014). Determinants of Maternal Healthcare Utilization in rural Kenya. Unpublished Master Thesis, School of Economics University of Nairobi.

Chuma, J., & Maina, T. (2014). Free maternal care and removal of user fees at primary-Level facilities in Kenya. Washington, DC: Health Policy Project.

Craigwell, R., Bynoe, D., & Lowe, S. (2012). The effectiveness of government expenditure on education and health care in the Caribbean. International Journal of Development Issues.

Crystal, S., Johnson, R., Harman, J., Sambamoorthi, U., & Kumar, R. (2000). Out-of-pocket health care costs among older Americans. J Gerontol Soc Sci, 55(1), S5I-62.

Fronstin, P.(2000). Small Employers and Health Benefits: Findings from the 2000 Small Employers Health Benefits Survey. Employee Benefit Research Institute Issue Brief No.226.

Geale, K. (2010). The effects of mothers’ education on the nutritional outcomes of their children in Nicaragua. SURG Journal, 3(2), 23-30.

Government of Kenya (2007). The Kenya Vision 2030.

Government of Kenya (2010). Constitution of Kenya. Nairobi: Government Printer Government of Kenya (2011), Public Expenditure Review: Policy for Prosperity.

Grossman, M. (1999). The Human Capital Model of the demand for Health. Working Paper No. 7078; National Bureau of Economic Research 1050 Massachusetts Avenue Cambridge, MA 02138.

Grossman, M. (2000). The Human Capital Model. Handbook of Health Economics Volume 1; City University of New York Graduates School & National Bureau of Economic Research.

Iram, U., & Butt, M. S. (2008). Socioeconomic determinants of child mortality in Pakistan. International Journal of Social Economics.

McNamee, P., Ternent, L., & Hussein, J. (2009). Barriers in accessing maternal healthcare: evidence from low-and middle-income countries. Expert review of pharmacoeconomics & outcomes research, 9(1), 41-48.

Kamau, ML (2016). Determinants for utilization of Free Maternal Services in Kenya. Unpublished thesis. University of Nairobi.

Kasina M (2017). Challenges Facing Pregnant Women In Accessing Free Maternity Services: (A Case Of Level Five And Six Hospitals In Kenya). Unpublished Thesis, University of Nairobi.

Kenya National Bureau of Statistics (2008). Kenya Demographic and Health Survey, KDHS 2008.ICF Macro.

Kenya National Bureau of Statistics (2014). Kenya Demographic and Health Survey, KDHS 2014. ICF Macro.

KNBS (2013). Kenya Household Health Expenditure and Utilization Survey (2013).Nairobi

Kimalu P. K. et al (2004), A Review of the Health Sector in Kenya. KIPPRA Discussion Paper No. 11

Machio, M.P. (2008). Demand for Maternal Health Care Services in Kenya. (Unpublished Master of Arts Research Paper). University of Nairobi.

Mackian, S., Bedri, N., & Lovel, H. (2004). Up the garden path and over the edge: where might health-seeking behaviour take us? Health Policy & Planning, 19(3), 137-146.

Maina M. (2006), Financing and Delivery of Healthcare in Kenya: Do the Poor Really Benefit from Public Health Spending? IPAR Discussion Paper Series No. 084/2006.

Manishimwe, C. (2011). Determinants of maternal Health care demand in Rwanda (Doctoral dissertation).

Kabubo-Mariara, J., Mwabu, D., & Ngeng'e, G. (2012). Inequality, poverty, growth and institutions: Understanding the linkages in Kenya.

Mbugua, S, and MacQuarrie, K L (2018). Maternal Health Indicators in High-Priority Counties of Kenya: Levels and Inequities. DHS Further Analysis Reports No. 110. Rockville, Maryland, USA: ICF.

Medrano, P., Rodríguez, C., & Villa, E. (2008). Does mother's education matter in child's health? Evidence from South Africa 1. South African Journal of Economics, 76(4), 612-627.

Ministry of Health (2013). Report on Maternal Health care in Kenya.

Ministry of Health (2017). Kenya National Health Accounts 2015/2016.

Kisiangani, I., Elmi, M., Bakibinga, P., Mohamed, S. F., Kisia, L., Kibe, P. M.& Noor, R. (2020). Persistent barriers to the use of maternal, newborn and child health services in Garissa sub-county, Kenya: a qualitative study. BMC Pregnancy and Childbirth, 20, 1-12.

Muriithi, M. K. (2013). The Determinants of Health-Seeking Behavior in a Nairobi Slum, Kenya. European Scientific journal, March 2013 ed. Vol. 9, No. 8.

Mwabu G. M. (1986). A Model of Household Choice among Medical Treatment Alternatives in Rural Kenya. A Paper presented to the B.U./Harvard/MIT Health Economics Seminar.

Mwabu G. M., Ainsworth, M. and Nyamete, A. (1994). Quality of Medical Care and Choice of Medical Treatment in Kenya: An Empirical Analysis, Journal of Human Resources Vol. 28 (4): 838-862.

Mwabu, G. (2008). The Production of Child Health in Kenya: A Structural Model of Birth Weight. Journal of Africa Economics.

Davis, N. L., Hoyert, D. L., Goodman, D. A., Hirai, A. H., & Callaghan, W. M. (2017). Contribution of maternal age and pregnancy checkbox on maternal mortality ratios in the United States, 1978–2012. American journal of obstetrics and gynecology, 217(3), 352-e1.

Ochako, R., Fotso, J. C., Ikamari, L., & Khasakhala, A. (2011). Utilization of maternal health services among young women in Kenya: insights from the Kenya Demographic and Health Survey, 2003. BMC pregnancy and childbirth, 11(1), 1.

Orayo, J. A (2014). Determinants of health insurance demand among the migrants in Kenya. Unpublished MSc. Health Economics Thesis, University of Nairobi.

Orayo, J. A. (2020). Determinants of Maternal Health Outcomes of Lactating Mothers in Meru County, Kenya. International Journal of Research in Education and Social Sciences (IJRESS), 3 (3) 1- 14.

Pillai, R. K., Williams, S. V., Glick, H. A., Polsky, D., Berlin, J. A., & Lowe, R. A. (2003). Factors affecting decisions to seek treatment for sick children in Kerala, India. Social Science & Medicine, 57(5), 783-790.

Ringel, J S. et al., (2002). The Elasticity of Demand for Healthcare; A Review of the Literature and Its Application to the Military Health System. RAND Corporation.

Rono, K. D. (2017). An appraisal of the role of Universal Periodic Review Mechanism in securing selected sexual reproductive and health rights in Kenya (Doctoral dissertation, University of Pretoria).

Sahn D. E., Younger, S. D. and Genicot G. (2003). The Demand for Healthcare Services in Rural Tanzania. Oxford Bulletin of Economics and Statistics 65: 241–59.

Sen A. (1992). Inequality Re-examined. Oxford: Clarendo Press. Chapter 7: Poverty and Affluence, pp. 102-116, ca. 7869

Shariff, A., & Singh, G. (2002). Determinants of maternal health care utilisation in India: evidence from a recent household survey (No. 85). New Dehli: National Council of Applied Economic Research.

Smith, K. V., & Sulzbach, S. (2008). Community-based health insurance and access to maternal health services: evidence from three West African countries. Social science & medicine, 66(12), 2460-2473.

Smith, K. P., & Christakis, N. A. (2008). Social networks and health. Annu. Rev. Sociol, 34, 405-429.

Sparrow, R., Suryahadi, A., & Widyanti, W. (2010). Social health insurance for the poor: targeting and impact of Indonesia's Askeskin program. Jakarta: SMERU Research Institute.

Suchman, L. (2018). Accrediting private providers with National Health Insurance to better serve low-income populations in Kenya and Ghana: a qualitative study. International journal for equity in health, 17(1), 179.

Kahneman, D., & Tversky, A. (1979). On the interpretation of intuitive probability: A reply to Jonathan Cohen.

United Nations (2013). Millennium Development Goals Progress Chart. Statistic Division, Department of Economic Affairs.

Wagstaff, A. and M. Lindelow (2008). Can Insurance Increase Financial Risk? The Curious Case of Health Insurance in China. Journal of Health Economics 27 (4): 990–1005.

Wagstaff, A. and M. Pradhan (2006). Health Insurance Impacts on Health and Nonmedical Consumption in a Developing Country. World Bank Policy Research. Working Paper; 563. Washington D.C.: World Bank.

Wagstaff, A., Lindelow, M., Jun, G., Ling, X., and Juncheng Q. (2009). Extending Health Insurance to the Rural Population: An Impact Evaluation of China’s New Cooperative Medical Scheme. Journal of Health Economics 28 (1): 1–19.

Wanyoike, A (2016). Determinants of demand for healthcare services in private hospitals in Kenya. Unpublished thesis, University of Nairobi.

World Health Organisation (1978). The Declaration of Alma Ata. WHO Policy Statement, Geneva, Switzerland

World Health Organization (2010). World Health Statistics 2010. Geneva: Switzerland.

World Health Organization (2005). The World Health Report 2005 Make every mother and child count, Geneva.

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Published

2020-09-17

How to Cite

George N. Mose, & Joseph Abuga Orayo. (2020). Health Insurance Deepening and Its Impact on Maternal Healthcare Demand in Private Hospitals in Kenya. JOURNAL OF SOCIAL SCIENCE RESEARCH, 16, 62–76. https://doi.org/10.24297/jssr.v16i.8855

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