1.1: BACKGROUND INFORMATION
National health insurance according to World Health Organization is a type of insurance coverage that pays for medical and surgical expenses incurred by the insured. The health insurance can reimburse the insured for the expenses incurred for the illness or injury or pay the care provider directly. Universal access to good quality healthcare remains a major concern of health systems globally including Kenya .Countries have adopted different mechanisms of financing healthcare, national health insurance playing a major role ,to ensure universal access to quality basic healthcare. Kenya spends 4.3% of GDP on health as per 2013 W.H.O statistics compared to 5.3% in Ghana, 4.6 % Benin and 3.9% Nigeria which are all very low compared to target of 15% of GDP to be used to finance health according to Abuja declaration of April 2001.
According to W.H.O ranking of world health systems, countries that have the best national health insurance policies include; Canada, United States of America, Britain, Australia, France ,Switzerland and Germany. In Canada for example, the government pays 70% of healthcare spending and spends just above 10% of GDP on health while in Australia the government pays 85% of outpatient and 75% of medical fees. France spends 11.8% of GDP on health. The worst country in the world in terms of national health insurance is the Republic of Sierra Leone which ranks 0.00 on W.H.O Health system performance index
Kenya ranks 140 according to W.H.O ranking of world’s health systems. Kenya is an African country situated in sub Saharan region. Agriculture is the major source of economy and more than 60% of Kenyans live below poverty line. Therefore subscribing to a national health insurance is of great importance because; it will lead to reduction in maternal and child mortality and morbidity since it will enhance prenatal and intra partum care and service, it will also lead to reduction in patient delay in seeking care and less progression of disease .Also life will be less hard for people with chronic disease I.e. diabetes mellitus since insurance pay for drugs and other aspects of care. It will also lead to establishment of high standard hospitals and motivation of doctors to work since both the hospital and the doctors are assured of payment. National health insurance will further lead to reduced personal expenditure on health and more healthy days which will lead to increased productivity.
1.2: PROBLEM STATEMENT
If people don’t subscribe to national health insurance cover and can’t afford healthcare it will lead to detrimental consequences which include; increased maternal and child mortality due to reduced prenatal and intra partum health care services seeking, it will also lead to delay in seeking health care and progression of disease since people will tent to wait till disease has advanced before seeking care. Life will be harder for people with chronic disease, for instance in diabetes mellitus, going without medication is not an option with or without insurance coverage. Hospitals and doctors will be under increased financial strains, some hospitals will close and relocate, residents especially in rural areas will have to travel further areas to access health care in the next available hospital .There will be a rise in unplanned pregnancies as some patients may not afford pregnancy control pills without insurance cover. There will also be reduced productivity since people can’t afford quality healthcare and therefore have more sick and disability days and less days to do economic activities. For this reasons, all Kenyans should have subscribed to national health insurance (NHIF). But surprisingly, only 20% of Kenyans have subscribed to medical cover. The burden of the problems stated above can be alleviated if Kenyans could subscribe to the national health insurance. Our study will aim to determine level of awareness, attitude and practices towards health insurance among the people of Kapkatet Township community, Kericho County, Kenya.
1.3: JUSTIFICATION OF THE STUDY
The study findings on awareness, attitude and practice towards health insurance among people of Kapkatet Township, Kericho County, Kenya will give information on the level of awareness, attitude and practice on health insurance in Kapkatet; proportion of people who have health insurance cover, barriers to taking health insurance cover. The information gathered will be a feedback to the government as the main provider of the national health insurance (NHIF) and major policy maker and private insurance. It will inform them whether to institute friendlier policies, increase awareness or try to find ways to mitigate the barriers to access or subscription of health insurance.