Effects of Socio-economic Status on Uptake of National Hospital Insurance Fund among Motorcycle Riders (Bodaboda) in Vihiga County, Kenya
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Abstract
Not much is known about the extent to which bodaboda riders in Kenya contribute to the National Hospital Insurance Fund (NHIF) through out-of-pocket payments. Bodabodas address mobility needs, create employment opportunities for youth and supplement household income within the informal sector. Access to healthcare services is influenced by various factors including demographics, socio-economic status, and overall health. Disparities in healthcare financing across different socio-economic groups in Kenya have been an ongoing topic of discussion. This study aimed to investigate whether socio-economic factors play a role in determining NHIF subscriptions among bodaboda riders in Vihiga County, Kenya. A cross-sectional survey was conducted among bodaboda riders in Vihiga County. The study employed a mixed-methods approach, utilizing a structured questionnaire to collect quantitative data from 384 participants, and interviewing for qualitative insights. The collected data encompassed socio-economic backgrounds and health insurance attributes. Analysis of the data was carried out using descriptive statistics and Chi-square tests with the SPSS (26).Target population was 10,000 bodabodas. A sample of 379 riders was interviewed, where (58%) were below 25 years of age, 60% lacked formal education, and 61% were responsible for school-going children. The findings indicated a significant correlation (p=0.004) between socio-economic factors and the adoption of NHIF medical coverage. However, the NHIF system did not receive substantial support from riders due to their limited income; 77% of the riders earned less than $60 per month, which hindered the social insurance scheme financial sustainability. In conclusion, the current health-financing model among motorcycle riders exhibits repressiveness due to the financial strain of substantial out-of-pocket expenses for medical treatment. To enhance equity and promote access to healthcare financing, there is an urgent need to come up with an affordable payment structure for boda boda riders, hence uplifting their livelihoods and viability of the NHIF system.
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