Effects of Perceived Image of NHIF Outpatient Facilities on Utilization of Primary Care Services by Private University Employees in Nairobi County

Abstract

The NHIF is a mandatory health insurance fund covering public and private formal sector workers and their dependents as the main health insurer in Kenya. NHIF has embarked on an ambitious reform program intended to convert it to a Social Insurance Health Scheme with an aim of serving as workers’ first pillar of social insurance. The national formal scheme members are entitled to all primary health services after selecting their preferred facilities from a list of the NHIF outpatient ones. However, there are some members of National formal scheme whose contributions are remitted to NHIF by their employer every month but do not utilize primary care services. This study sought to determine the effects of perceived image of NHIF outpatient facilities on utilization of primary care services by the national formal scheme members in Nairobi with a focus on Private University employees. This study adopted a cross-sectional descriptive design with mixed methods approach. Multistage sampling with simple random sampling was used. Quantitative techniques were used for data collection. Descriptive statistics, F-Statistics, P-values, Pearson’s Rho ®, mean-scores, standard deviations, co-efficient of determination (R2) and the coefficient of multiple determinations (Adjusted R2) were analyzed using SPSS version 24. The rationale of this study was to inform top management of NHIF to undertake decisions in regards to utilization of primary health services by NHIF members by understanding effects of safety of healthcare services, waiting time at the health facilities, healthcare workers interpersonal skills and facilities amenities and physical outlook affect utilization of primary care services. The multiple regression results indicates that in a combined relationship only three factors on perceived image of NHIF facilities influence utilization of primary care services; safety of healthcare services (X1; β1 = .315, P ˂0.05), healthcare workers interpersonal skills (X3; β3 = .0.049, P ˂0.05), and healthcare facilities amenities and physical outlook (X4; β4 = .027, P ˂0.05). Waiting time is negative (X2; β2 = -.018, P ˂0.05) and thus does not influence utilization of primary care services. In a combined model, all four factors have no scientifically significant influence on utilization of primary health services by national formal scheme members in Nairobi County. The study recommends that NHIF should vet facilities they accredit to offer primary care services to ensure safety of healthcare services, train workers on effective interpersonal skills and improve facility amenities and physical outlook of NHIF outpatient facilities