Willingness to renew national hospital insurance fund among voluntary scheme members in Kajiado County-Kenya

Objective: This study established determinants for readiness to renew the NHIF (national hospital Insurance fund) among informal sector national scheme members in Kenya for universal health coverage (UHC).
Methods: This was a cross sectional survey on 394 purposively sampled national health insurance members in Kajiado County. Data was collected through questionnaires rated on a 5-point Likert scale. Binary logistic regression was used to establish the significant determinants associated with the willingness to renew the insurance covers. P-values of less than 0.05 were considered statistically significant.
Results: Majority of the participants were male (n=266, 67.5%), over 36 years of age (n=330, 83.7%), married (n=200, 50.8%) and lived in large households of over 3 people (n=358, 90.9%). Overall, respondents showed high willingness to continue paying the insurance premiums and renew their insurance covers for health services (Median: 3.86, IQR 0.75). Controlling for all factors, married (AOR 15.6, 2.3-106.4), large household sizes with more than 3 people, low household income per month (less than KSh. 5000), awareness of NHIF fund services (AOR 13.2, 3.1-55.5), service provider factors (AOR 109, 14.8-803.8) and adverse selection on willingness to renew (AOR 0.043, 0.009-0.202) were significant determinants of willingness to renew the insurance cover (p<0.05).
Conclusion: Individual factors - married, belonging to larger household, and lower income group, awareness of NHIF services and system/external factors - service provider’s factors and adverse selection on the other hand influenced willingness to renew insurance covers. There is need to increase the community’s awareness on the health insurance risk-benefits through member education and improve access to quality health services in the health facilities to enhance renewal of the NHIF covers by members.