Health insurance status of female caregivers and its effect on the utilization of oral healthcare for children with HIV/AIDS in Nairobi, Kenya

Aims: Dental caries is a public health concern in many developing nations like Kenya. Slum children often do not have access to oral health care, and their oral health-related quality of life (OHRQoL) remains largely un-researched topic in Kenya. The present study was designed to determine the prevalence and severity of dental caries and its impact on the OHRQoL of a cohort of slum-dwelling children in a Nairobi slum. Methods: This was a hospital-based mixed methods cross-sectional study carried out at the out-patient HIV-care clinics at Getrude Children’s hospital (GCH), Kenyatta National Hospital (KNH) and Mbagathi County and Referral Hospital (MCRH) in Nairobi City County, Kenya. The study involved 221 female caregivers of children with HIV/AIDS and their health workers at the HIV-care clinics. Results: More than two-thirds (68%) of the respondents did not have any form of health insurance to facilitate access to medical and/or dental healthcare. More than three quarters (76%) of those who had utilized oral healthcare services for their children paid from out-of-pocket (OOP) expenses. There was gross underutilization of the National Health Insurance Fund, NHIF, with only 18% of the respondents having been enrolled. Conclusion: Underutilization of social health insurance by caregivers, compounded by OOP spending for health services imposes limitations on the utilization of oral healthcare for children with HIV/AIDS.