Abstract:
INTRODUCTION
Non-communicable diseases (NCDs) are increasingly becoming important causes of
illness and premature deaths globally, causing up to 41 million deaths annually, mostly occurring
in Low and Middle-Income Countries. However, NCD treatment is lengthy and expensive forcing
households to incur catastrophic expenditure. Thus, NCDs deepen inequality and are major
drivers of unending poverty due to their lengthy treatment. Kenya successively reformed the
National Health Insurance Fund to include a package that covers the plight of NCDs and
transform it into a primary enabler for achieving Universal Health Coverage. This study
examined whether health insurance affects catastrophic health expenditure among households of
people with NCDs.
METHODOLOGY
A quasi-experimental design was conducted among eligible households with health
insurance and those without, involving a representative sample of 350 households. Trained
interviewers conducted interviews at baseline and after one year with household heads.
RESULTS
Households without cover spent a higher proportion of their total income (23%) on NCD
care compared to households with insurance (11.7%). The mean total expenditure on NCD care
for insured households was Ksh. 8,657.37 (95% CI 7,061.6 - 10,253.1) while that for non-insured
was Ksh. 16,851.20 (95% CI 15,255.4 - 18,445.0), p = 0.000. Although the proportion of un-insured
households that incurred catastrophic health expenditure (CHE) was higher than that of insured
households, the study failed to establish that the incidence of CHE was different for non-insured
and insured households (𝝌𝟐 = 33.89, df =1, p = 0.062).
CONCLUSION
NHIF cover was unable to protect Households of People with NCDs from CHE. The study
recommends that NHIF's benefits package be further reformed to adequately cover all NCD's
care needs. County government to strengthen the health system and boos
