FINANCIAL BENEFITS OF ENLISTING IN MUTUAL HEALTH SCHEMES AMONG LOW-INCOME HOUSEHOLDS IN KIRINYAGA COUNTY, KENYA
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Keywords:
Out-of-Pocket Payments, Mutual Health Organization, Catastrophic Health ExpenditureAbstract
Purpose: Examining the financial benefits of enlisting in mutual health schemes among low-income households in Kirinyaga County
Material and methods: Descriptive cross-sectional study design was employed, where 315 participants were picked using multistage sampling techniques. Semi-structured questionnaire and in-depth interviews were the primary data collection methods, with both descriptive and inferential statistics being employed at the analytic stage.
Findings: Results indicate that 59.3% of households utilising out-of-pocket benefited from membership to cushion their family from difficulties of accessing healthcare services. Other financial benefits include protection against the cost of illness, providing access to prioritised care, third-party influence for non-members to subscribe, and productive value such as accessing quality treatment, improving living standards, avoiding debts, and increasing their saving kitty. Enlisting to MHO also reduced gender-based, education-based, and cadre-based sociodemographic differentials.
Unique Contribution to Theory, Practice and Policy: While MHOs are critical in reducing household healthcare expense, improving financial accessibility, as well as redressing sociodemographic differentials during care-seeking events among low-income households, there is a need for preparing reports on beneficiaries to help the management understand social dynamics surrounding the operations of the schemes. There is also a need for investigating healthcare seeking behaviours of beneficiaries as some persons did not utilise mutual schemes. There is also need for further research to validate the contribution of mutual health schemes in other areas as well as assess strategies of increasing the access for all socioeconomic factions
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References
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Onoka, C., Onwujekwe, O., Hanson, K. and Uzochukwu, B. (2011). Examining catastrophic health expenditures at variable thresholds using household consumption expenditure diaries. Tropical Medicine & International Health, 16(10), pp.1334-1341.
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Polonsky, J., Balabanova, D., McPake, B., Poletti, T., Vyas, S., Ghazaryan, O., & Yanni, M. K. (2009). Equity in community health insurance schemes: evidence and lessons from Armenia. Health Policy and Planning, 24(3), 209-216.
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Saksena, P., Antunes, A. F., Xu, K., Musango, L., & Carrin, G. (2010). Impact of mutual health insurance on access to health care and financial risk protection in Rwanda. World health report.
Twahirwa, A. (2008). Sharing the burden of sickness: mutual health insurance in Rwanda. Bulletin of the World Health Organization, 86(11), pp.823-824.
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Wagstaff, A. (2008). Measuring Financial Protection in Health. Papers.ssrn.com. Retrieved 28 February 2016, from http://papers.ssrn.com/sol3/papers.cfm?abstract_id=1106043
Wagstaff, A. and Doorslaer, E. (2003). Catastrophe and impoverishment in paying for health care: with applications to Vietnam 1993-1998. Health Econ., 12(11), pp.921-933.
Whitehead, M., Dahlgren, G. and Evans, T. (2001). Equity and health sector reforms: can low-income countries escape the medical poverty trap?. The Lancet, 358(9284), pp.833-836.
Whitehead, M., Dahlgren, G., & Evans, T. (2001). Equity and health sector reforms: can low-income countries escape the medical poverty trap?. The Lancet, 358(9284), 833-836. http://dx.doi.org/10.1016/s0140-6736(01)05975-x
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Xu, K., Evans, D., Kawabata, K., Zeramdini, R., Klavus, J. and Murray, C. (2003). Household catastrophic health expenditure: a multicountry analysis. The Lancet, 362(9378), pp.111-117.
Yip, W., Subramanian, S. V., Mitchell, A. D., Lee, D. T., Wang, J., & Kawachi, I. (2007). Does social capital enhance health and well-being? Evidence from rural China. Social science & medicine, 64(1), 35-49.
Atim, C. (1998). Contribution of mutual health organizations to financing, delivery, and access to health care. Synthesis of research in nine West and Central African countries Bethesda MD: Abt Associates Inc.
PwC. (2018). Medical cost trend: Behind the numbers 2019. Retrieved from https://www.pwc.com/us/en/health-industries/health-research-institute/behind-the-numbers.html
Bevan, G., Helderman, J. and Wilsford, D. (2010). Changing choices in health care: implications for equity, efficiency and cost. HEPL, 5(03), pp.251-267.
Ministry of Medical Services, Ministry of Public Health and Sanitation. Kenya National Health Accounts 2009/10. Nairobi; 2011. Health System 20/20. Accessed on 25/08/2018 on http://www.who.int/pmnch/media/events/2013/kenya_nha.pdf
Carrin, G., Waelkens, M. P., & Criel, B. (2005). Community‐based health insurance in developing countries: a study of its contribution to the performance of health financing systems. Tropical medicine & international health, 10(8), 799-811.
Chankova, S., Sulzbach, S. and Diop, F. (2008). The impact of mutual health organizations: evidence from West Africa. Health Policy and Planning, 23(4), pp.264-276.
Chuma, J. and Maina, T. (2012). Catastrophic health care spending and impoverishment in Kenya. BMC Health Services Research, 12(1).
Chuma, J. and Okungu, V. (2011). Viewing the Kenyan health system through an equity lens: implications for universal coverage. International Journal for Equity in Health, 10(1), p.22.
Chuma, J., Gilson, L., and Molyneux, C. (2007). Treatment-seeking behaviour, cost burdens and coping strategies among rural and urban households in Coastal Kenya: an equity analysis. Tropical Medicine & International Health, 12(5), pp.673-686.
Chuma, J., Mulupi, S., & McIntyre, D. (2013). Providing financial protection and funding health service benefits for the informal sector: Evidence from sub-Saharan Africa. London, UK: KEMRI—Wellcome Trust Research Programme, University of Cape Town.
Citizen TV, (2016). Monday Special: Burden of Disease. [video] Available at: https://www.youtube.com/watch?v=y72ze8s6MH0 [Accessed 25 Jul. 2016].
Fiedler, J. and Suazo, J. (2002). Ministry of Health user fees, equity and decentralization: lessons from Honduras. Health Policy and Planning, 17(4), pp.362-377.
Franco, L. M., Diop, F. P., Burgert, C. R., Kelley, A. G., Makinen, M., & Simpara, C. H. T. (2008). Effects of mutual health organizations on the use of priority health-care services in urban and rural Mali: a case-control study. Bulletin of the World Health Organization, 86(11), 830-838.
Galárraga, O., Sosa-Rubí, S. G., Salinas-Rodríguez, A., & Sesma-Vázquez, S. (2010). Health insurance for the poor: impact on catastrophic and out-of-pocket health expenditures in Mexico. The European Journal of Health Economics, 11(5), 437-447.
Gnawali, D. P., Pokhrel, S., Sié, A., Sanon, M., De Allegri, M., Souares, A., ... & Sauerborn, R. (2009). The effect of community-based health insurance on the utilization of modern health care services: evidence from Burkina Faso. Health policy, 90(2), 214-222.
Habib, S. S., Perveen, S., & Khuwaja, H. M. A. (2016). The role of micro health insurance in providing financial risk protection in developing countries-a systematic review. BMC public health, 16(1), 281
Haddad, S., Ridde, V., Yacoubou, I., Mák, G. and Gbetié, M. (2012). An Evaluation of the Outcomes of Mutual Health Organizations in Benin. PLoS ONE, 7(10), p.e47136.
Jehu-Appiah, C., Aryeetey, G., Spaan, E., De Hoop, T., Agyepong, I., & Baltussen, R. (2011). Equity aspects of the National Health Insurance Scheme in Ghana: Who is enrolling, who is not and why?. Social Science & Medicine, 72(2), 157-165.
Johnston, H. (2009). Relationships of Exclusion and Cohesion with Health: The Case of Bangladesh. J Health Popul Nutr, 27(4).
Jütting, J. P. (2004). Do community-based health insurance schemes improve poor people’s access to health care? Evidence from rural Senegal. World development, 32(2), 273-288.
Kotsila, P. (2014). Socio-political and cultural determinants of diarrheal disease in the Mekong Delta. Wien: LIT.
Lu, C., Liu, Y., & Shen, J. (2012). Does China's rural cooperative medical system achieve its goals? Evidence from the China Health Surveillance Baseline Survey in 2001. Contemporary Economic Policy, 30(1), 93-112.
Mulupi, S., Kirigia, D. and Chuma, J. (2013). Community perceptions of health insurance and their preferred design feature: implications for the design of universal health coverage reforms in Kenya. BMC Health Services Research, 13(1).
Mushi, D. (2009). Rethinking Universal Access to Public Health-Care: User Fees do not Necessarily Constitute the Major Barrier. TJDS, 7(1).
Narayan, D. (2011). Voices of the Poor - International Development Studies (1st ed.). Retrieved from http://www.ids-uva.nl/wordpress/wp-content/uploads/2011/09/1-Voices-of-the-Poor.pdf
O'Donnell, O. (2008). Analyzing health equity using household survey data. Washington, D.C.: World Bank.
Onoka, C., Onwujekwe, O., Hanson, K. and Uzochukwu, B. (2011). Examining catastrophic health expenditures at variable thresholds using household consumption expenditure diaries. Tropical Medicine & International Health, 16(10), pp.1334-1341.
Perrin, K. M. (2014). Essentials of planning and evaluation for public health. Jones & Bartlett Publishers.
Polonsky, J., Balabanova, D., McPake, B., Poletti, T., Vyas, S., Ghazaryan, O., & Yanni, M. K. (2009). Equity in community health insurance schemes: evidence and lessons from Armenia. Health Policy and Planning, 24(3), 209-216.
Pradhan, M. and Prescott, N. (2002). Social risk management options for medical care in Indonesia. Health Econ., 11(5), pp.431-446.
Russell, S. (2004). The Economic Burden of Illness for Households in Developing Countries: A Review of Studies Focusing on Malaria, Tuberculosis, and Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome. American Society of Tropical, Medicine, and Hygiene. [online] Available at: http://www.ncbi.nlm.nih.gov/books/NBK3768/ [Accessed 21 Jul. 2016].
Saksena, P., Antunes, A. F., Xu, K., Musango, L., & Carrin, G. (2010). Impact of mutual health insurance on access to health care and financial risk protection in Rwanda. World health report.
Twahirwa, A. (2008). Sharing the burden of sickness: mutual health insurance in Rwanda. Bulletin of the World Health Organization, 86(11), pp.823-824.
Van Doorslaer, E., O'Donnell, O., Rannan-Eliya, R., Somanathan, A., Adhikari, S., Garg, C., Harbianto, D., Herrin, A., Huq, M., Ibragimova, S., Karan, A., Ng, C., Pande, B., Racelis, R., Tao, S., Tin, K., Tisayaticom, K., Trisnantoro, L., Vasavid, C. and Zhao, Y. (2006). Effect of payments for health care on poverty estimates in 11 countries in Asia: an analysis of household survey data., The Lancet, 368(9544), pp.1357-1364.
Wagstaff, A. (2008). Measuring Financial Protection in Health. Papers.ssrn.com. Retrieved 28 February 2016, from http://papers.ssrn.com/sol3/papers.cfm?abstract_id=1106043
Wagstaff, A. and Doorslaer, E. (2003). Catastrophe and impoverishment in paying for health care: with applications to Vietnam 1993-1998. Health Econ., 12(11), pp.921-933.
Whitehead, M., Dahlgren, G. and Evans, T. (2001). Equity and health sector reforms: can low-income countries escape the medical poverty trap?. The Lancet, 358(9284), pp.833-836.
Whitehead, M., Dahlgren, G., & Evans, T. (2001). Equity and health sector reforms: can low-income countries escape the medical poverty trap?. The Lancet, 358(9284), 833-836. http://dx.doi.org/10.1016/s0140-6736(01)05975-x
WHO, (2005). Sustainable health financing, universal coverage, and social health insurance. In: Health financing for universal coverage. [online] Geneva. Available at: http://www.who.int/health_financing/documents/cov-wharesolution5833/en/ [Accessed 25 Jul. 2016].
Xu, K., Evans, D., Carrin, G., Aguilar-Rivera, A., Musgrove, P., & Evans, T. (2007). Protecting Households From Catastrophic Health Spending. Health Affairs, 26(4), 972-983. http://dx.doi.org/10.1377/hlthaff.26.4.972
Xu, K., Evans, D., Kawabata, K., Zeramdini, R., Klavus, J. and Murray, C. (2003). Household catastrophic health expenditure: a multicountry analysis. The Lancet, 362(9378), pp.111-117.
Yip, W., Subramanian, S. V., Mitchell, A. D., Lee, D. T., Wang, J., & Kawachi, I. (2007). Does social capital enhance health and well-being? Evidence from rural China. Social science & medicine, 64(1), 35-49.
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Published
2018-09-11
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Munyua, T., Rucha, D. K., & Yitambe, D. A. (2018). FINANCIAL BENEFITS OF ENLISTING IN MUTUAL HEALTH SCHEMES AMONG LOW-INCOME HOUSEHOLDS IN KIRINYAGA COUNTY, KENYA. Global Journal of Health Sciences, 3(2), 39 – 53. Retrieved from https://www.iprjb.org/journals/index.php/GJHS/article/view/712
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