Determinants of enrollment and retention of organized members of the informal sector into National Hospital Insurance Fund Nairobi County
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The global agenda focus is on how countries can adopt context specific initiatives towards realizing Universal Health Coverage as emphasis by the post 2015 development agenda(United Nations, 2015). The Kenya health financing strategy (2017) emphasis on Universal Health Coverage and envisions the National Hospital Insurance Fund (NHIF) as the primary provider of health insurance as the vehicle for delivery of UHC. The study sought to assess the determinants of enrolment and retention of organized groups of the informal sector into the NHIF Kenya with the aim of contributing to the knowledge on how social health insurance schemes can achieve Universal Health Coverage. The study target population was the informal sector members of organized groups (Self-help groups) in Kibera constituency Nairobi County. The objectives of the study were; to assess the views of informal sector workers about the improved benefit package , to describe the knowledge of benefit entitlements among organized members of the informal sector in Kibera and to examine access to the entitlements in terms of availability, affordability and accessibility. A descriptive cross-sectional study design was adopted with mixed method approach and sample size of 88 respondents from the study population was interviewed using a semi structured interview guide. Qualitative data were analyzed using content analysis, Quantitative data were entered into the statistical, package for social sciences (SPSS) version 24 and organized for statistical data analysis using descriptive statistics. The findings were summarized and presented using tables, figures and percentages. The result findings were that the members of the informal sector in Kibera view NHIF membership as essential and would recommend it to potential members. Majority of respondents are aware of 59 % of the NHIF benefit entitlements whereas 41% are not aware. Access of entitlements as a determinant of enrollment was assessed and it was found out that the distance to the accredited facilities was within World Health Organization recommendations and the benefit package was affordable and acceptable however 54% of the respondents stated that the benefits were not available at the chosen health care providers and thus affected utilization of these benefits and their satisfaction with the benefit package . The unmet demand of the benefit package therefore influenced the perception of NHIF and enrollment and retention of the informal sector.