Financial and Geographic Barriers to Health Care Access in Kenya: The Quest towards Universal Health Coverage

IF 1.7 4区 医学 Q3 HEALTH POLICY & SERVICES
Obiero Brian Odhiambo, K. Purity
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Abstract

The Quest towards Abstract Background : Access to health care services without being plunged into financial hardship is a life blood of the Universal Health Coverage. Kenya’s health sector is heavily dependent on out of pocket health expenditure. This model of health financing is inequitable and leads to underutilization of the much needed health care services. Majority of Kenyans travel for longer distances to access health care services. The geographic access barrier is linked to delayed care, missed appointments, delayed medication and undue loss of life. This study examines the correlates of financial and geographic health care access barriers in the UHC implementing Counties in Kenya. Methodology : The study used a cross-sectional data collected from 249 respondents using exit interviews at the health facilities drawn from the Kenya Master Health Facility List (KMHL). A multivariate log it regression model was used to analyze the predictors of probability of failure to access health care services owing to prohibitive health care and transport costs. Results: High out-of-pocket monthly expenditure on medicine; wider proximity, higher transportation cost and a longer traveling time to a health facility increases the probability of not seeking medical treatment owing to prohibitive health care and transportation costs. These factors thus, acts as key barriers to health care access. Conclusion : Financial and geographic access barriers negatively impact on health care access. To hasten the realization of the Universal Health Coverage, prepayment models such as use of taxes and insurance should be pursued.
肯尼亚获得医疗保健的财政和地理障碍:实现全民健康覆盖的努力
摘要背景:在不陷入经济困难的情况下获得卫生保健服务是全民健康覆盖的生命线。肯尼亚卫生部门严重依赖自付卫生支出。这种卫生筹资模式不公平,导致急需的保健服务得不到充分利用。大多数肯尼亚人需要长途跋涉才能获得保健服务。地理准入障碍与延误护理、错过预约、延误用药和不必要的生命损失有关。本研究考察了肯尼亚实施全民健康覆盖县的财政和地理卫生保健准入障碍的相关性。方法:该研究使用了从249名受访者中收集的横断面数据,这些受访者使用了从肯尼亚总卫生设施清单(KMHL)中抽取的卫生设施的离职访谈。采用多变量对数回归模型分析了由于高昂的医疗费用和运输费用而无法获得医疗服务的概率预测因素。结果:月自费药费较高;距离较近、运输费用较高以及前往保健设施的旅行时间较长,增加了由于高昂的保健和运输费用而不寻求治疗的可能性。因此,这些因素成为获得保健服务的主要障碍。结论:经济和地理障碍对卫生保健可及性有负面影响。为加快实现全民健康覆盖,应采用税收和保险等预付模式。
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来源期刊
Journal of Healthcare Management
Journal of Healthcare Management HEALTH POLICY & SERVICES-
CiteScore
2.00
自引率
5.60%
发文量
68
期刊介绍: The Journal of Healthcare Management is the official journal of the American College of Healthcare Executives. Six times per year, JHM offers timely healthcare management articles that inform and guide executives, managers, educators, and researchers. JHM also contains regular columns written by experts and practitioners in the field that discuss management-related topics and industry trends. Each issue presents an interview with a leading executive.
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