| dc.description.abstract | Globally, utilization of Social Health Insurance is wanting and Africa South of the
Sahara is the worst affected. In Kenya and more specifically Trans Nzoia County,
utilization of social health Insurance services under the brand name Linda Mama
Boresha Jamii Insurance (LMBJI) which the Kenya government is utilizing to offer
free maternity services to expectant women in order to reduce maternal death rate
remains a challenge despite the government’s effort to create awareness. According to
Hospital Insurance Fund (NHIF), Trans Nzoia County office records out of 45,472
women who were eligible to use Linda Mama card only 6,453(14%) women used
Linda Mama card during their ante natal period in 2017 and during delivery only
6,430(14%) used Linda Mama card. The broad study objective was determining
factors influencing utilization of LMBJI cover in Trans Nzoia County. The study was
under the Health Financing Pillar of the Health Systems Management. This study
adopted descriptive-cross sectional research design with mixed methods approach.
The research study was institutional based and it targeted women of reproductive age
with confirmed pregnancy and those with babies less than one-year-old. The study
had a target population of 45,472.A sample size of 384 was obtained using Cochran’s
sample size formula (1977), while 7 Nursing Services Managers working in the
sampled health facilities were sampled using purposive sampling technique and were
used as key informants. The study also used purposive sampling technique to realize
the health facilities study sample. Data collection tools were structured questionnaire
for the 384 mothers to realize quantitative data. The study further used key informant
interview guide for 7 Nursing Services Managers to realize qualitative data. The
research tools were pretested to ascertain reliability and validity. SPSS version 25 was
used in coding and analyzing the quantitative data while qualitative data was analyzed
thematically and presented in verbatim. The regression equation, taking all factors
(Client’s characteristics, NHIF Scheme Characteristics, health facility factors and
Health Worker’s Characteristics) to be constant at zero, growth of Linda Mama would
be 1.217. The data findings analyzed also showed that taking all other independent
variables at zero, a unit increase in Client’s characteristics leads to a 0.746 increase in
Utilization of Linda mama; a unit increase in NHIF Scheme Characteristics leads to a
0.778 increase in Utilization of Linda mama, a unit increase in health facility factors
leads to a .673 increase in utilization of Linda mama; while a unit increase in health
worker’s characteristics leads to a .622 increase in Utilization of Linda mama. This
inferred that NHIF Scheme Characteristics, health facility factors, health worker’s
characteristics, had the most influence on Utilization of Linda mama with a
significance value of (0.000) at 95% level of confidence followed by Client’s
characteristics with a significance value of 0.002. The study found out and concluded
that client’s characteristics, NHIF scheme characteristics, health facility factors and
health worker’s characteristics influenced utilization of Linda mama insurance policy.
The study recommended that the implementers of the programme in Trans Nzoia
County should focus on improving economic status of the women by creating
conducive environment for doing business; the county government of Trans Nzoia
should also make sure all roads leading to rural health facilities are passable
especially during rainy season while the NHIF scheme should develop and adopt a
mobile phone application which can allow as many expectant mothers as possible to
register without necessarily visiting health facilities. | en_US |
