Influence of Registration Process in Health Insurance Utilization among NHIF Members in Isiolo County

Abstract

Registration for the health insurance is a critical process in the uptake and subsequent utilization of the health insurance and low enrollment leads to poor service utilization and this increases household health expenditure on health (OOP) and there is the need to assess the actors that affects registration process. The study objective was to establish the role of registration in health insurance on utilization of healthcare services among NHIF members in Isiolo County. Specific objectives included: to assess the influence of accuracy of data captured, knowledge of registration details, communication about registration process and the time taken to complete the registration process on utilization of healthcare services in Isiolo County, Kenya. This was cross-section study design. The target population were all NHIF insured households in Isiolo County. The study sample size 384 households who had NHIF health insurance participated and who had resided in Isiolo County for at least 12 months. The study used purposive sampling technique hereby only those respondents that had national health insurance were included int the study. A semi-structured questionnaire was used to collect data. The tool was pre-tested in the same county and Cronbach alpha of 0.7 as obtained and an ethical approval was obtained from KeMU Science, Ethics, and Research Committee and a permit for the research from the NACOSTI and the Isiolo County Health Office respectively. Quantitative data was

coded, entered and analyzed using SPSS v25. Results revealed that these socio- demographic factors, marital status, occupation status and number of the member of

households were all-significant and they influenced utilization of healthcare services using the NHIF insurance cover. Majority 357(93.5%) and 339(88.7%) knew how to select health facility and the benefits entitled to them respectively. Nearly all 361(94.8%) cited that their personal data was correctly captured in the NHIF database. Error in personal included wrong date of birth / age, wrong name. Majority 283(74.1%) pointed that it took them less than one hour to register for their NHIF insurance while most 303(79.3%) indicated that they got their membership cards on time. knowledge of the registration details, communication of registration process and time taken for registration were significant in determining the utilization of healthcare services among the respondents and was significant(p<0.1). Knowledge of registration details (requirements) a great role in the enrollment to the of health insurance programmes and thus NHIF should emphasize on the mass education on the necessity of enrollment in health insurance schemes (public or private) and the various requirements that are required to complete the process through the use of effective channel of communication to the end users/beneficiaries of those health schemes. Parastatal such as NHIF Isiolo branch and other private insurance firms should carryout mass sensitization frequently through various channels such as newspaper, TV and radio adverts on importance of enrollment and registration and their associated insurance package benefits advantages and as this would increase their health insurance utilization. Health services providers such as Isiolo County Referral hospital management team should communicate to their clients on importance of enrollment and registration information details to the end consumer in order to enroll for the insurance programmes on entails contents, time and place of registration as this would greatly reduce the consumers OOP.