Determinants of health insurance ownership among women in Kenya: evidence from the 2008–09 Kenya demographic and health survey

BACKGROUND The Government of Kenya is making plans to implement a social health insurance program by transforming the National Hospital Insurance Fund (NHIF) into a universal health coverage program. The objective of this study was to examine the determinants associated with health insurance ownership among women in Kenya. METHODS Data came from the 2008-09 Kenya Demographic and Health Survey, a nationally representative survey. The sample comprised 8,435 women aged 15-49 years. Descriptive statistics and multivariable logistic regression analysis were used to describe the characteristics of the sample and to identify factors associated with health insurance ownership. RESULTS Being employed in the formal sector, being married, exposure to the mass media, having secondary education or higher, residing in households in the middle or rich wealth index categories and residing in a female-headed household were associated with having health insurance. However, region of residence was associated with a lower likelihood of having insurance coverage. Women residing in Central (OR = 0.4; p < 0.01) and North Eastern (OR = 0.1; p < 0.5) provinces were less likely to be insured compared to their counterparts in Nairobi province. CONCLUSIONS As the Kenyan government transforms the NHIF into a universal health program, it is important to implement a program that will increase equity and access to health care services among the poor and vulnerable groups.