Contribution of community based health insurance on access to healthcare: Afya yetu scheme, chehe sub-location, Nyeri county, Kenya

Field: Health Professions (Health Sciences)

How to finance and provide health care for the more than 1.3 billion rural poor and informal \nsector workers in low- and middle-income countries is one of the greatest challenges facing the \ninternational development community. Community Based Healthcare Insurance schemes \n(CBHIS) like other solidarity based insurance initiatives have the goal of finding ways for \ncommunities to meet their health financing needs through pooled revenue collection and resource \nallocation decisions made by the community. They provide insurance services by allowing \nmembers to pay small premiums on a regular basis to offset the risk of needing to pay large \nhealthcare fees upon falling sick. This study was set to establish the contribution of the CBHIS \ntowards access to healthcare by the members of Afya Yetu scheme in Chehe sub-location, \nMathira East Sub -County, Nyeri County. The objectives were to establish how sensitization of \nmembers influences access to healthcare; establish how risk pooling influences access to \nhealthcare by members; assess how linkages with nearby healthcare providers contributes to \naccess of healthcare and to establish how the choice of an insurance benefit package affects \naccess to healthcare. This study uses a descriptive survey design chosen so as to enable the \nresearcher to describe the state of affairs at the scheme. The unit of analysis consists of a sample \nof 120 subjects systematically sampled from a target population of 289. The data was collected \nusing a questionnaire which had both open and close ended questions. A pilot study comprising \nof 10 respondents was conducted in an adjacent sub-location and the output was used to ensure \ncompleteness of data collection instrument. Questionnaires for the committee members were self \nadministered while the others were researcher administered. Data collected was both qualitative \nand quantitative; qualitative data is analyzed using content analysis the quantitative data was \ncoded and entered into statistical package for social sciences version 20 and analyzed using \ndescriptive statistics. Findings of the study show that 66.7% of the leaders indicated that the \nawareness of members affects the way they seek healthcare while 82.5% of the contributors \nindicated that the knowledge gained by being in the scheme had changed the way they sought \nhealth care. The researcher concludes that access to health insurance can have a positive impact \non their members’ economic and social situation. To enlarge access to health care for the poor \nand the rural population, community-based health insurance schemes can be an important \nelement and a first step. It allows some limited pooling of risks and thereby leads to an \nimprovement in the health care system, where most people otherwise have to pay their health \nexpenditure out of pocket. The research findings are of benefit to the organization implementing \nthis programme and others doing the same in other areas as they can utilize the recommendations \nadvanced by the study.