Factors Influencing Use of Linda Mama Boresha Jamii Health Insurance by Expectant Mothers In Trans Nzoia County, Kenya

Abstract

Generally, utilization of maternal and child health insurance around the globe is wanting, and African countries that lie South of the Sahara are the worst affected. Consequently, Kenyan government has established free maternity services (FMS) for all expectant mothers and children under one year. FMS insurance is offered under the brand name Linda Mama Boresha Jamii Insurance (LMBJI). However, access to maternal child health (MCH) services using LMBJI remains wanting in Trans Nzoia County. Based on population and housing census (2009), out of 45,472 estimated deliveries in 2017, only 6453(14%) utilized LBJI insurance service. The broad objective of this study was to establish factors that influence utilization of Linda Mama Boresha Jamii Insurance in Trans Nzoia County. The study adopted a cross-sectional design with mixed data collection methods. The target population was 45,472, and sample comprised 384 mothers and seven nursing services managers operating in the sampled facilities within Trans Nzoia County. Data collection tools were structured questionnaire for the 384 mothers; and a key informant tool for the seven nursing services managers. SPSS was used to analyze quantitative data, while qualitative data was analyzed thematically and presented in verbatim. The regression equation, in a combined relationship of all factors, namely; clients’ characteristics, NHIF scheme characteristics, health facility factors and health workers’ characteristics, indicated a positive effect, and were statistically significant in utilization of MCH services using LMBJI. The study recommended that Trans Nzoia County Government should ensure accessibility to rural health facilities, especially during rainy seasons, by repairing rural access roads; that it should empower women economically by providing enabling environment for them to do business; and that NHIF should adopt a mobile phone application which can allow as many expectant mothers as possible to register into LBJI without necessarily visiting preferred health facilities.